University of Iowa Hospitals & Clinics/Medical Service Plan – Family Medicine Physician, NPI 1477554814
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for University of Iowa Hospitals & Clinics/Medical Service Plan
105 E 9th St
Coralville, IA 522412209
Phone: (319) 467-2000
Fax: (319) 467-2410
Type: Location
920 E 2nd Ave Ste 201A&b
Coralville, IA 522412219
Phone: (319) 467-2000
Fax: (319) 467-2410
Type: Location
2701 Prairie Meadow Dr
Iowa City, IA 522428001
Phone: (319) 384-7070
Fax: (319) 467-8247
Type: Location
University of Iowa Hospitals & Clinics, 200, Hawkins Drive, Iowa City, Johnson County, Iowa, 52245, United States
IOWA CITY, IA 522421009
Phone: (319) 356-1616
Fax: (319) 384-5164
Type: Mailing
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: 2025-12-31
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Revalidation due soon
Earliest CMS due date is 2026-07-31 (51 days away).
Enrollment records
31
Earliest due date
2026-07-31
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 |
|---|---|---|---|---|
| O20091221000403 | O | Clinic/Group Practice | IL | 2026-09-30 |
| O20140626002579 | O | Clinic/Group Practice | SD | TBD |
| O20200818001184 | O | Clinic/Group Practice | WA | 2026-07-31 |
| O20201020000616 | O | Clinic/Group Practice | CA | 2026-08-31 |
| O20220510000048 | O | Clinic/Group Practice | PA | TBD |
| O20230201000752 | O | Clinic/Group Practice | VA | TBD |
| O20230206003187 | O | Clinic/Group Practice | TX | TBD |
| O20230306000360 | O | Clinic/Group Practice | FL | TBD |
| O20230927002975 | O | Clinic/Group Practice | WI | TBD |
| O20231214001065 | O | Clinic/Group Practice | NJ | TBD |
| O20240108000661 | O | Clinic/Group Practice | SC | TBD |
| O20240109000130 | O | Clinic/Group Practice | MA | TBD |
| O20240307001096 | O | Clinic/Group Practice | TN | TBD |
| O20240307001678 | O | Clinic/Group Practice | AL | TBD |
| O20240314001874 | O | Clinic/Group Practice | CT | TBD |
| O20240314002768 | O | Clinic/Group Practice | NY | TBD |
| O20240403003040 | O | Clinic/Group Practice | CO | TBD |
| O20240404000204 | O | Clinic/Group Practice | MO | TBD |
| O20240404002510 | O | Clinic/Group Practice | MI | TBD |
| O20240518000402 | O | Clinic/Group Practice | MD | TBD |
| O20240614002033 | O | Clinic/Group Practice | OR | TBD |
| O20240701003498 | O | Clinic/Group Practice | AZ | TBD |
| O20240709002661 | O | Clinic/Group Practice | UT | TBD |
| O20240716002484 | O | Clinic/Group Practice | NE | TBD |
| O20240910003659 | O | Clinic/Group Practice | DC | TBD |
| O20241106000329 | O | Clinic/Group Practice | GA | TBD |
| O20241204004389 | O | Clinic/Group Practice | MS | TBD |
| O20250123001460 | O | Clinic/Group Practice | NC | TBD |
| O20250214003369 | O | Clinic/Group Practice | NM | TBD |
| O20251218002897 | O | Clinic/Group Practice | NH | TBD |
| O20251231001385 | O | Clinic/Group Practice | KY | TBD |
What to do next
- Confirm the due date on the CMS Revalidation Lookup Tool.
- Complete revalidation in PECOS before the published due date.
- If you have multiple enrollment records, revalidate each one on its own schedule.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 52241)
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