Provider Demographics
NPI:1801856638
Name:RHEINGANS, PATRICK P (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:P
Last Name:RHEINGANS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 E 53RD ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2710
Mailing Address - Country:US
Mailing Address - Phone:563-359-3949
Mailing Address - Fax:
Practice Address - Street 1:1970 E 53RD ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2710
Practice Address - Country:US
Practice Address - Phone:563-359-3949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA310852085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1160440Medicaid
IA2160440OtherMEDICAID IOWA W/ ORA
IAK51235OtherMEDICARE ORA ILLINOIS
IA20775OtherMEDICARE W/ ORA
300088437OtherRR MDC RGPCSC
32920OtherBCBS IA RGIC LLC
IA6160440Medicaid
IA20775OtherBCBS OF IOWA W/ ORA
IA300125721OtherRAILROAD MEDICARE W/ ORA
300132295OtherRR MDC RGIC LLC
32921OtherBCBS IA RGPCSC
32921Medicare ID - Type UnspecifiedRGPCSC
IA1160440Medicaid
I6034Medicare ID - Type UnspecifiedRGIC LLC