Michael Jonathan Khadavi, MD

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

04-37406 Issued in KS

Practice address

10777 Nall Ave Ste 300
Overland Park, KS 66211-1330

Phone

(913) 642-0200

Fax

(913) 563-6699

NPI assigned

May 1, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, KS2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physical Medicine and RehabilitationAlso: Sports Medicine

Education

University of Kansas School of Med (KC/Wich/Sal), 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dickson Diveley Midwest Orthopaedic Clinic LLCGroup PAC ID 1153225479, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kansas City Orthopaedic Institute Hospital, Leawood, KS, CCN 170188
• Adventhealth Shawnee Mission Hospital, Shawnee Mission, KS, CCN 170104
• Saint Luke'S South Hospital Hospital, Overland Park, KS, CCN 170185
• NKC Health Hospital, North Kansas City, MO, CCN 260096

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicmobile.corp.saint-lukes.org/FHIRPROXY/api/FHIR/R4/
• Direct secure messaging: michael.khadavi@direct.tmcmed.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dickson Diveley Midwest Orthopaedic Clinic LLC

  • Orthopaedic Surgery Physician
  • Leawood, KS
  • NPI 1669421509

  MO

  Medicare reassignment Care Compare group NPD
• Dickson Diveley Midwest Orthopaedic Clinic LLC

  • Durable Medical Equipment & Medical Supplies
  • Lenexa, KS
  • NPI 1730946302
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kansas City Orthopaedic Institute LLC

  • General Acute Care Hospital
  • Leawood, KS
  • NPI 1457364408
  Care Compare affiliation
• Saint Lukes South Hospital, Inc.

  • General Acute Care Hospital
  • Overland Park, KS
  • NPI 1154303337
  Care Compare affiliation
• Shawnee Mission Medical Center Inc

  • General Acute Care Hospital
  • Merriam, KS
  • NPI 1023171634
  Care Compare affiliation
• Shawnee Mission Medical Center Inc

  • Clinical Medical Laboratory
  • Merriam, KS
  • NPI 1235792003

  Hospital

  Care Compare affiliation
• North Kansas City Hospital

  • Skilled Nursing Facility
  • North Kansas City, MO
  • NPI 1437103215

  Hospital

  Care Compare affiliation
• North Kansas City Hospital

  • General Acute Care Hospital
  • North Kansas City, MO
  • NPI 1629062799
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1241136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1003050204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10777 NALL AVE STE 300",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111330",
            "telephone_number": "913-642-0200",
            "fax_number": "913-563-6699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10777 NALL AVE STE 300",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111330",
            "telephone_number": "913-642-0200",
            "fax_number": "913-563-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHADAVI",
        "first_name": "MICHAEL",
        "middle_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-01",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "MO",
            "license": "2010026613",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "KS",
            "license": "04-37406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan Z Kessler, D.O.
• Joseph L Kessler, O.D.
• Christopher S Ketcherside, MD
• Kevin Stallbaumer, D.C. LLC
• Sarah Franceen Key, PT, DPT
• Sampada Khadka
• Tina Khaleghi
• Sheba Khalid, M.D. L.L.C.
• Ammar Khalifa, MD
• Aroog Khaliq, MD

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.