GOSHORN PSYCH-SERVICES PLLC – Psychiatric/Mental Health Nurse Practitioner, NPI 1477857704
Psychiatric/Mental Health Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for GOSHORN PSYCH-SERVICES PLLC
2213 GRAND AVE
DES MOINES, IA 503125305
Phone: (515) 237-3974
Fax: (515) 883-2692
Type: Mailing
410 E ROBINSON ST
SUITE A-2
KNOXVILLE, IA 501382058
Phone: (641) 205-3100
Fax: (641) 205-3102
Type: Location
1501 50TH ST STE 110
WEST DES MOINES, IA 502665920
Phone: (515) 421-3679
Fax: (888) 203-7693
Type: Mailing
935 W 18TH ST S
NEWTON, IA 502083500
Phone: (641) 871-0764
Fax: (641) 792-2745
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: 2011-01-31
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-08-31 (283 days ago).
Enrollment records
1
Earliest due date
2025-08-31
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 |
|---|---|---|---|---|
| O20110131000697 | O | Clinic/Group Practice | IA | 2025-08-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 50312)
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