1. Home
  2. Directory
  3. Iowa
  4. Clive
  5. Urology
  6. NPI Profile

UROLOGY CENTER OF IOWA PLLC
NPI 1689210155
Urology in Clive, IA

Active since November 20, 2019CLIA Certified · 6 labs
12129 UNIVERSITY AVE, CLIVE, IA 50325(515) 400-3550 Get Directions Write a Review

NPPES record last updated: March 12, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 12, 2026, Nov 26, 2025, Jul 17, 2024 and 3 more (6 updates tracked since 2019).

About Urology Center Of Iowa Pllc NPPES

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

UROLOGY CENTER OF IOWA PLLC (NPI 1689210155) is a healthcare organization registered as an urology in Clive, Iowa and active in the NPI registry since November 2019. The organization holds 6 active CLIA laboratory certificates and lists Mark Kellerman, Managing Member/partner, as its authorized official.

NPPES Registry Identity

NPI1689210155
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameUROLOGY CENTER OF IOWA PLLC
Location Address12129 UNIVERSITY AVEClive, IA 50325-8287
Mailing Address12129 University AveClive, IA 50325-8287
Phone(515) 400-3550
Organization SubpartNo
Authorized OfficialMark KellermanManaging Member/partner · (515) 249-1610
Enumeration DateNovember 20, 2019
Last NPPES UpdateMarch 12, 20266 updates tracked since enumeration
NPPES CertifiedMarch 12, 2026
✔ NPI 1689210155 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Definition
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.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
12129 UNIVERSITY AVE, Clive, IA 50325
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Urology Center Of Iowa Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

35

Medicare enrollment records show 35 clinicians reassign Medicare billing to Urology Center Of Iowa PLLC, which bills Medicare for the services they deliver. Of these, 11 practice at this address and 21 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 6

Urology13
Nurse Practitioner8
Pathology7
Diagnostic Radiology3
Interventional Radiology3
Nuclear Medicine1

Nearest to this location (20)

See all 35
Stephanie Courson Pothoven, DO
Urology
NPI 1033230560
12129 UNIVERSITY AVE STE 100
Clive, IA 50325
(515) 400-3550
✔ PECOS✔ Accepts MedicareSame address
Marcy Covert, FNP-C
Nurse Practitioner
NPI 1992464325
12129 UNIVERSITY AVE STE 100
Clive, IA 50325
(515) 400-3550
✔ PECOS✔ Accepts MedicareSame address
Ryan Dornbier
Urology
NPI 1609294305
12129 UNIVERSITY AVE STE 100
Clive, IA 50325
(515) 400-3550
✔ PECOS✔ Accepts MedicareSame address
Brian Gallagher, M.D.
Urology
NPI 1336358324
12129 UNIVERSITY AVE STE 100
Clive, IA 50325
(515) 400-3550
✔ PECOS✔ Accepts MedicareSame address
Jacob Jipp, M.D.
Urology
NPI 1164886644
12129 UNIVERSITY AVE STE 100
Clive, IA 50325
(515) 400-3550
✔ PECOS✔ Accepts MedicareSame address
Mark Kellerman, M.D.
Urology
NPI 1891780995
12129 UNIVERSITY AVE STE 100
Clive, IA 50325
(515) 400-3550
✔ PECOS✔ Accepts MedicareSame address
Mccabe Kenny, M.D.
Urology
NPI 1164721338
12129 UNIVERSITY AVE STE 100
Clive, IA 50325
(515) 400-3550
✔ PECOS✔ Accepts MedicareSame address
Karman Pflughaupt, ARNP
Nurse Practitioner
NPI 1497612931
12129 UNIVERSITY AVE
Clive, IA 50325
(515) 400-3550
✔ PECOS✔ Accepts MedicareSame address
Brittany Rygg, FNP
Nurse Practitioner
NPI 1841802378
12129 UNIVERSITY AVE
Clive, IA 50325
(515) 400-3550
✔ PECOS✔ Accepts MedicareSame address
Taylor Whitt, NP
Nurse Practitioner
NPI 1639796667
12129 UNIVERSITY AVE STE 100
Clive, IA 50325
(515) 400-3550
✔ PECOS✔ Accepts MedicareSame address
Trevor Wild, M.D.
Urology
NPI 1881969111
12129 UNIVERSITY AVE STE 100
Clive, IA 50325
(513) 400-3550
✔ PECOS✔ Accepts MedicareSame address
Jared Abbott, M.D.
Pathology
NPI 1073598512
4637 121ST ST
Urbandale, IA 50323
(515) 655-7080
✔ PECOS✔ Accepts Medicare3.1 mi
Renee Ellerbroek, MD
Pathology
NPI 1962510099
4637 121ST ST
Urbandale, IA 50323
(515) 655-7080
✔ PECOS✔ Accepts Medicare3.1 mi
Caitlin Halverson, M.D.
Pathology
NPI 1548588395
4637 121ST ST
Urbandale, IA 50323
(515) 655-7080
✔ PECOS✔ Accepts Medicare3.1 mi
Tiffani Milless, M.D.
Pathology
NPI 1912172776
1212 PLEASANT SUITE #LL3
Des Moines, IA 50309
(515) 241-8861
✔ PECOS✔ Accepts Medicare7.8 mi
Tawnya Bauch, ARNP
Nurse Practitioner
NPI 1184093080
1221 PLEASANT STREET SUITE 100
Des Moines, IA 50309
(515) 282-2921
✔ PECOS✔ Accepts Medicare7.8 mi
Alyson Lieser, ARNP
Nurse Practitioner
NPI 1588277404
1111 6TH AVE
Des Moines, IA 50314
(515) 247-4240
✔ PECOS✔ Accepts Medicare8.3 mi
Vilma Bramasco, ARNP
Nurse Practitioner
NPI 1528787074
5608 SW 9TH ST
Des Moines, IA 50315
(515) 285-3070
✔ PECOS✔ Accepts Medicare9.5 mi
Kevin Birusingh, M.D.
Urology
NPI 1497915300
1350 DES MOINES ST STE 100
Des Moines, IA 50309
(515) 643-0400
✔ PECOS✔ Accepts Medicare9.6 mi
Richard Glowacki, M.D.
Urology
NPI 1679567663
1350 DES MOINES ST STE 100
Des Moines, IA 50309
(515) 643-0400
✔ PECOS✔ Accepts Medicare9.6 mi
See all 35 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 6

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 16D2187364

Urology Center Of Iowa · Clive, IA
Active · expires Jun 30, 2028
CLIA Number16D2187364
Laboratory TypePhysician Office
Certificate Effective DateJuly 1, 2026
Certificate Expiration DateJune 30, 2028
Laboratory DirectorRichard L. Glowacki
Laboratory Phone(515) 400-3550
Laboratory LocationUrology Center Of Iowa12129 University Ave, Clive, IA 50325
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 16D2342888

Urology Center Of Iowa - Wellness Center · Clive, IA
Active · expires Apr 27, 2028
CLIA Number16D2342888
Laboratory TypePhysician Office
Certificate Effective DateApril 28, 2026
Certificate Expiration DateApril 27, 2028
Laboratory DirectorStephanie Pothoven
Laboratory Phone(515) 400-3550
Laboratory LocationUrology Center Of Iowa - Wellness Center12129 University Ave Ste 210, Clive, IA 50325
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 16D2342890

Urology Center Of Iowa · Clive, IA
Active · expires Apr 27, 2028
CLIA Number16D2342890
Laboratory TypePhysician Office
Certificate Effective DateApril 28, 2026
Certificate Expiration DateApril 27, 2028
Laboratory DirectorKevin K. Birusingh
Laboratory Phone(515) 400-3550
Laboratory LocationUrology Center Of Iowa12129 University Ave Ste 250, Clive, IA 50325
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 16D2183029

Urology Center Of Iowa · Clive, IA
Active · expires Mar 29, 2027
CLIA Number16D2183029
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateMarch 30, 2025
Certificate Expiration DateMarch 29, 2027
Laboratory DirectorTiffani Milless
Laboratory Phone(515) 400-3550
Laboratory LocationUrology Center Of Iowa12129 University Ave, Clive, IA 50325
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 16D2310971

Urology Center Of Iowa Research, LLC · Clive, IA
Active · expires Sep 12, 2028
CLIA Number16D2310971
Laboratory TypeClinical Research
Certificate Effective DateSeptember 13, 2026
Certificate Expiration DateSeptember 12, 2028
Laboratory DirectorBrian Gallagher
Laboratory Phone(515) 992-7718
Laboratory LocationUrology Center Of Iowa Research, LLC12129 University Ave, Ste 200, Clive, IA 50325
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 16D2322505

Urology Center Of Iowa · Ankeny, IA
Active · expires Apr 21, 2027
CLIA Number16D2322505
Laboratory TypePhysician Office
Certificate Effective DateApril 22, 2025
Certificate Expiration DateApril 21, 2027
Laboratory DirectorBrian Gallagher
Laboratory Phone(515) 400-3550
Laboratory LocationUrology Center Of Iowa800 E First St Ste 2300, Ankeny, IA 50021
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Urology Center Of Iowa PLLC's NPI number?

The NPI number for Urology Center Of Iowa PLLC is 1689210155. It was assigned to this organization in the NPPES registry on November 20, 2019.

Where is Urology Center Of Iowa PLLC located?

Urology Center Of Iowa PLLC is located at 12129 University Ave, Clive, IA 50325. The listed phone number is (515) 400-3550.

What is Urology Center Of Iowa PLLC's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Urology Center Of Iowa PLLC enrolled in Medicare?

Yes. Urology Center Of Iowa PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Urology Center Of Iowa PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 35 clinicians in 6 Medicare specialties reassign their Medicare billing to Urology Center Of Iowa PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Urology (13), Nurse Practitioner (8) and Pathology (7). Of these, 11 practice at this address and 21 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Urology Center Of Iowa PLLC hold CLIA laboratory certificates?

Yes. 6 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Urology Center Of Iowa PLLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 30 other insurers list Urology Center Of Iowa PLLC 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.

When was this NPI record last updated?

The NPPES record for Urology Center Of Iowa PLLC was last updated on March 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.