ADULT & PEDIATRIC UROLOGY PC (NPI# 1437282308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437282308 |
| Entity Type | Organization |
| Organization Name | ADULT & PEDIATRIC UROLOGY PC |
| Practice Address |
3434 W Broadway Suite 102 Council Bluffs IA 51501-3291 |
| Mailing Address |
Po Box 8577 Omaha NE 68108-0577 |
| Practice Telephone | 4023977989 |
| Practice Fax Number | 7123289196 |
| Mailing Telephone | 4023977989 |
| Mailing Fax Number | 4023978703 |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. EUCLID J DESOUZA (CEO) |
| Authorized Official Telephone | 4023977989 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0424739 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245363654 | Adult & Pediatric Urology PC | Urology | 631 N 8th St, Missouri Valley, IA 51555 | 2007-03-14 |
| 1730212614 | Adult & Pediatric Urology PC | Urology | 2206 Longo Dr, Ste 105, Bellevue, NE 68005-2977 | 2007-03-13 |
| 1003949918 | Adult & Pediatric Urology PC | Urology | 1213 Garfield Ave, Harlan, IA 51537-2057 | 2007-03-13 |
| 1831222702 | Adult & Pediatric Urology PC | Urology | 17055 Frances St, Ste 102, Omaha, NE 68130-4655 | 2007-03-13 |
| 1568595452 | Adult & Pediatric Urology PC | Urology | 1501 E 10th St, Atlantic, IA 50022-1936 | 2007-03-13 |
| Street Address |
3434 W BROADWAY SUITE 102 |
| City | COUNCIL BLUFFS |
| State | IA |
| Zip Code | 51501-3291 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164538674 | Joseph M Wanzek IIi | Family Medicine | 3434 W Broadway, Suite 100, Council Bluffs, IA 51501-3291 | 2006-08-21 |
| 1255548897 | Wendy Marie Johnson | Physician Assistant | 3434 W Broadway, Council Bluffs, IA 51501-3291 | 2007-05-16 |
| 1194898296 | Bluffs Family Health Care PC | Internal Medicine | 3434 W Broadway, Council Bluffs, IA 51501-3291 | 2006-11-16 |
| 1891868980 | Scott D Blair | Family Medicine | 3434 W Broadway, Council Bluffs, IA 51501-3291 | 2006-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881204691 | Melissa Sue Sperry | Counselor | Melissa Sperry, 4036 Ramelle Dr, Council Bluffs, IA 51501 | 2020-08-06 |
| 1326689076 | Crc Recovery, Inc. | Clinic/Center | 1750 W Broadway, Council Bluffs, IA 51501 | 2019-10-03 |
| 1518451152 | Naomi Kigondu | Registered Nurse | 2323 W Broadway Ste 100, Council Bluffs, IA 51501 | 2018-06-18 |
| 1710400361 | Travis John Alger | Chiropractor | 3424 W Broadway, Council Bluffs, IA 51501 | 2017-07-25 |
| 1124495692 | Jillian Kahl | Speech-Language Pathologist | 1500 N 16th St, Council Bluffs, IA 51501 | 2015-08-31 |
| 1932584323 | Leigh Healey | Dietitian, Registered | 2323 West Broadway, Council Bluffs, IA 51501 | 2015-07-27 |
| 1942558523 | Karen Irene Godin | Registered Nurse | 1702 N 16th Street, Council Bluffs, IA 51501 | 2012-08-29 |
| 1063787505 | Rebecca F Aboe | Dietitian, Registered | 1702 North 16th St., Council Bluffs, IA 51501 | 2012-03-16 |
| 1972883122 | Sara Ann Lott | Occupational Therapist | 1310 N. 17th St., Council Bluffs, IA 51501 | 2011-08-19 |
| 1700042884 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 3271 Marketplace Dr, Council Bluffs, IA 51501 | 2008-07-29 |
| Find all providers in zip 51501 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871944017 | Ahmed Alkaram | Urology | 1229 Hunters Run, Iowa City, IA 52246-8670 | 2016-06-29 |
| 1548414188 | Garrett Steven Korrect | Urology | 1215 Duff Avenue., Mcfarland Clinic. PC, Ames, IA 50010-3014 | 2008-11-10 |
| 1083898779 | Alexandria Urology P.C. | Urology | 112 Park Lane, Room 5, Waterloo, IA 50701 | 2007-12-18 |
| 1194930081 | Damon J. Dyche | Urology | 1215 Duff Ave., Mcfarland Clinic, PC, Ames, IA 50010-3014 | 2007-05-14 |
| 1407831365 | Burlington Urology PC | Urology | 400 S Broadway St, Burlington, IA 52601 | 2005-12-13 |
| 1124018999 | Paul E.l. Richardson | Urology | 3410 Kimball Ave, Waterloo, IA 50702-5735 | 2005-10-24 |
| 1679567663 | Richard L Glowacki | Urology | 1350 Des Moines St Ste 100, Des Moines, IA 50309-5507 | 2005-09-06 |
| 1801889472 | Markham J Anderson | Urology | 2943 Northgate Dr, Iowa City, IA 52245-9571 | 2005-08-29 |
| 1003818493 | Fawad Sabooh Zafar | Urology | 13682 Lake Shore Dr, Clive, IA 50325-8640 | 2005-08-15 |
| 1205834793 | Gordon Goldsmith | Urology | 2943 Northgate Drive, Iowa City, IA 52245 | 2005-07-08 |
| Find all providers with the same taxonomy | ||||
| City | COUNCIL BLUFFS |
| Zip Code | 51501 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.