TIFFANY KETCHAM (DO) – Family Medicine Physician, NPI 1699786962
Family Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
1,656 FAMILY PRACTICE in IA
Provider Addresses for TIFFANY KETCHAM (DO)
PO BOX 424
DES MOINES, IA 503020424
Phone: (515) 875-9925
Fax: (515) 875-9923
Type: Mailing
825 NE GATEWAY DR STE 148
GRIMES, IA 501111307
Phone: (515) 875-9607
Fax: (515) 875-9608
Type: Location
Des Moines Post Office, 1165, 2nd Avenue, Des Moines, Polk County, Iowa, 50318, United States
DES MOINES, IA 503051475
Phone: (515) 270-1177
Fax: (515) 643-9361
Type: Mailing
Merle Hay Centre, 6200, Aurora Avenue, Urbandale, Polk County, Iowa, 50322, United States
URBANDALE, IA 503222800
Phone: (515) 270-1177
Fax: (515) 643-9361
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-01-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100119000372 | I | Family Practice | IA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
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 |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 410 | 219 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 354 | 182 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 313 | 167 | $0 |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 204 | 169 | $0 |
| 83036 | Hemoglobin a1c level | 88 | 63 | $0 |
Insurance plans in this area (ZIP 50302)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | IA | 90670 | Pneumococcal vaccine for injection into muscle | 30 | 30 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | IA | |
| Nurse Practitioner | IA | |
| P O D I A T R Y | IA | |
| Internal Medicine | IA | |
| Family Practice | IA | |
| - | IA | |
| Family Practice | IA | |
| Orthopedic Surgery | MO | |
| Internal Medicine | IA | |
| Family Practice | IA |
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