Provider Demographics
NPI:1760455083
Name:SCHMADEKE, THOMAS Z (PA)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:Z
Last Name:SCHMADEKE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:IA
Mailing Address - Zip Code:51566-1305
Mailing Address - Country:US
Mailing Address - Phone:712-623-5534
Mailing Address - Fax:712-623-7279
Practice Address - Street 1:1400 SENATE AVE
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:IA
Practice Address - Zip Code:51566-1271
Practice Address - Country:US
Practice Address - Phone:712-623-5534
Practice Address - Fax:712-623-7279
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9796363A00000X
IA001920363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P89158Medicare UPIN
IAP89158Medicare UPIN