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JUSTIN MATTHEW FRAZIER
NPI 1477248870
Student in an Organized Health Care Education/Training Program in West Des Moines, IA

Active since April 10, 2023PECOS Enrolled
415 34TH ST, WEST DES MOINES, IA 50265(612) 559-6488 Get Directions Write a Review

NPPES record last updated: April 10, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Justin Matthew Frazier NPPES

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

JUSTIN MATTHEW FRAZIER (NPI 1477248870) is an individual student in an organized health care education/training program in West Des Moines, Iowa, licensed in Colorado (PDT.0000614) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS and is a graduate of College Of Podiatric Med And Surgery, Des Moines University (2023).

NPPES Registry Identity

NPI1477248870
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJUSTIN MATTHEW FRAZIER
Location Address415 34TH STWest Des Moines, IA 50265-4023
Mailing Address415 34th StWest Des Moines, IA 50265-4023 · (612) 559-6488
Phone(612) 559-6488
Sole ProprietorYes
Medical School CMSCollege Of Podiatric Med And Surgery, Des Moines UniversityGraduated 2023
Enumeration DateApril 10, 2023
NPPES CertifiedApril 10, 2023
✔ NPI 1477248870 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in CO · PDT.0000614
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
415 34TH ST, West Des Moines, IA 50265
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Justin Matthew Frazier is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9133693427
PECOS Enrollment IDI20260708001296
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.

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 Justin Frazier's NPI number?

The NPI number for Justin Frazier is 1477248870. It was assigned to this individual provider in the NPPES registry on April 10, 2023.

Where is Justin Frazier located?

Justin Frazier practices at 415 34th St, West Des Moines, IA 50265. The listed phone number is (612) 559-6488.

What is Justin Frazier's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Justin Frazier enrolled in Medicare?

Yes. Justin Frazier is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Justin Frazier was last updated on April 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.