Unknown Individual – Physician Assistant, NPI 1669570404
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
1123 1ST AVE E
SUITE 200
NEWTON, IA 50208
Phone: (641) 792-4012
Fax: (641) 275-3085
Type: Mailing
200, 4th Avenue West, Grinnell, Grant Township, Poweshiek County, Iowa, 50112, United States
GRINNELL, IA 50112
Phone: (641) 236-6137
Fax: (641) 236-0206
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $218.
Total Amount is formed as General ($218) + Research ($0) + Ownership ($0) = $218.
Last reported payment date: 2023-09-13 • Largest payer in this snapshot: Teva Pharmaceuticals USA, Inc. ($105).
Total Amount
$218
General + Research + Ownership
Payments
11
Total payment records
General Amount
$218
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-09-13
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 37 | 16 | $0 |
| 96127 | Assessment of emotional or behavioral problems | 34 | 12 | $0 |
Insurance plans in this area (ZIP 50208)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Mental Health Counselor | IA | |
| - | IA | |
| Physician Assistant | IA | |
| - | IA | |
| Nurse Practitioner | IA | |
| Physician Assistant | IA | |
| Physician Assistant | IA | |
| P S Y C H I A T R Y | IA | |
| Clinical Social Worker | IA | |
| Mental Health Counselor | IA |
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