DR. DJONGGI W SITUMEANG MD
NPI 1396824165
Family Medicine in Mt Pleasant, IA

Active since November 03, 2006PECOS EnrolledAccepts Medicare Assignment
85.12/100
CMS Quality Rating
501 S WHITE ST, SUITE 1, MT PLEASANT, IA 52641(319) 385-6700(319) 385-6703 Get Directions Write a Review

NPPES record last updated: October 12, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Djonggi W Situmeang Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DJONGGI W SITUMEANG MD (NPI 1396824165) is an individual family medicine provider in Mt Pleasant, Iowa, licensed in Iowa (29357) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS, is affiliated with Southeast Iowa Regional Medical Center, and is a graduate of Mayo Medical School (1992).

NPPES Registry Identity

NPI1396824165
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. DJONGGI W SITUMEANGCredential: MD
Location Address501 S WHITE ST, SUITE 1Mt Pleasant, IA 52641-2600
Mailing Address501 S White St, Suite 1Mt Pleasant, IA 52641-2600 · (319) 385-6700 · Fax (319) 385-6703
Fax(319) 385-6703
Sole ProprietorNo
Medical School CMSMayo Medical SchoolGraduated 1992
Enumeration DateNovember 3, 2006
Last NPPES UpdateOctober 12, 2007
NPI 1396824165 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in IA · 29357
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
501 S WHITE ST, Mt Pleasant, IA 52641

Other Identifiers 3

Medicare UPINF35869IA
Medicaid3086926IA
Medicare PIN55647IA

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Djonggi W Situmeang Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4284665910
PECOS Enrollment IDI20091211000562
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 35

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
1,422 services186 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
1,381 services467 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
769 services433 patients
Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439
Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.
364 services123 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
318 services318 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
313 services108 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Southeast Iowa Regional Medical Center

Acute Care Hospitals · West Burlington, IA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number160057
Location1221 South Gear AvenueWest Burlington, IA 52655 · Des Moines County
Emergency services Birthing friendly

Henry County Health Center

Critical Access Hospitals · Mount Pleasant, IA
OwnershipGovernment - Local
CMS Certification Number161356
Location407 S White StMount Pleasant, IA 52641 · Henry County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 52641 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.84 typical visit price
range $52.96 – $161.40
Typical copayment $20.46 (range $13.24 – $40.35)
Most-billed visit code 99203
Established Patient
$94.05 typical visit price
range $16.91 – $131.98
Typical copayment $23.51 (range $4.22 – $32.99)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

85.12/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality95.95
Promoting Interoperability100
Improvement Activities40
Cost54.47

Reported Quality Measures

Appropriate Treatment for Upper Respiratory Infection (URI)
90%30 patients4/55-star benchmark: 100%
Breast Cancer Screening
76%293 patients4/55-star benchmark: 93%
Cervical Cancer Screening
40%358 patients2/55-star benchmark: 98%
Childhood Immunization Status
14%21 patients
Chlamydia Screening for Women
17%94 patients
Closing the Referral Loop: Receipt of Specialist Report
65%370 patients4/55-star benchmark: 87%
Controlling High Blood Pressure
77%636 patients4/55-star benchmark: 91%
Dementia: Cognitive Assessment
4%27 patients
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
13%174 patients4/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
94%4,166 patients4/55-star benchmark: 100%
e-Prescribing
100%2,973 patients5/55-star benchmark: 100%
HIV Screening
5%955 patients1/55-star benchmark: 60%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
22%1,382 patients1/55-star benchmark: 98%
Provide Patients Electronic Access to Their Health Information
97%1,441 patients4/55-star benchmark: 100%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 1% · 572 patients
Patients totalRate: 13% · 612 patients
14%612 patients3/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 22

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
5 suppliers53 claims98 services$5.81 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
3 suppliers14 claims14 services$1.05 avg. paid by Medicare
Ostomy skin barrier, powder, per oz A4371
DME-Orthotic Devices · category DF010N
2 suppliers15 claims15 services$3.48 avg. paid by Medicare
Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each A5057
DME-Orthotic Devices · category DF010N
1 supplier14 claims560 services$9.29 avg. paid by Medicare
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing A6209
DME-Medical/Surgical Supplies · category DA023N
1 supplier17 claims90 services$6.81 avg. paid by Medicare
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing A6222
DME-Medical/Surgical Supplies · category DA023N
1 supplier11 claims98 services$1.85 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Radiology (Diagnostic Radiology)
501 S WHITE ST
MT PLEASANT, IA 52641
Family Medicine
501 S WHITE ST, SUITE 1
MT PLEASANT, IA 52641
Physician Assistant
501 S WHITE ST, SUITE 1
MT PLEASANT, IA 52641
Clinic/Center (Ambulatory Surgical)
501 S WHITE ST, SUITE 105
MOUNT PLEASANT, IA 52641
Dentist (General Practice)
501 S WHITE ST
MT PLEASANT, IA 52641
Family Medicine
501 S WHITE ST, SUITE ONE
MT PLEASANT, IA 52641
Internal Medicine
501 S WHITE ST, SUITE ONE
MT PLEASANT, IA 52641
Physician Assistant (Medical)
501 S WHITE ST, SUITE 1
MT PLEASANT, IA 52641

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Djonggi Situmeang's NPI number?

The NPI number for Djonggi Situmeang is 1396824165. It was assigned to this individual provider in the NPPES registry on November 3, 2006.

Where is Djonggi Situmeang located?

Djonggi Situmeang practices at 501 S White St Suite 1, Mt Pleasant, IA 52641. The listed phone number is (319) 385-6700.

What is Djonggi Situmeang's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Djonggi Situmeang enrolled in Medicare?

Yes. Djonggi Situmeang is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Djonggi Situmeang accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan and 1 other insurer list Djonggi Situmeang as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Djonggi Situmeang affiliated with any hospitals?

According to CMS data, Djonggi Situmeang is affiliated with Southeast Iowa Regional Medical Center and Henry County Health Center.

When was this NPI record last updated?

The NPPES record for Djonggi Situmeang was last updated on October 12, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.