Individual provider Active NPI

Austin Mayes Petz

  • Emergency Medicine Physician
  • Kansas City, KS
National Provider Identifier
1023696655
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
04-49740 Issued in KS
Practice address
4000 Cambridge St
Kansas City, KS 66160-8501
Phone
(913) 588-1559
NPI assigned
Apr 2, 2021
Last updated
Aug 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 04-49740 KS Primary

Addresses

Primary practice location

4000 Cambridge St
Kansas City, KS 66160-8501

Mailing address

9100 W 74TH St
Overland Park, KS 66204-4004
Phone (913) 676-2214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241202003089 KS Practitioner - Emergency Medicine 0244633873 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ER Physicians South, P.a.Group PAC ID 2860458544, 33 clinicians
Em Specialists PAGroup PAC ID 1153452644, 14 clinicians

Practice addresses (Care Compare)

1301 S Main St
Ottawa, KS 66067-3537
Phone (781) 280-1589

9100 W 14TH St
Shawnee Mission, KS 66204-4004
Phone (913) 676-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-49740KSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Em Specialists PA Emergency Medicine CurrentSince Sep 23, 2024 Accepting new patients

Locations

1301 S Main St
Ottawa, KS 66067
Phone (785) 229-3367

7025 College Blvd
Overland Park, KS 66211
Phone (913) 632-3500

7820 W 165th St
Overland Park, KS 66223
Phone (913) 232-9846

9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230

Organizations & group practices 2

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

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1023696655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 W 74TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662044004",
            "telephone_number": "913-676-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 CAMBRIDGE ST",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608501",
            "telephone_number": "913-588-1559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETZ",
        "first_name": "AUSTIN",
        "middle_name": "MAYES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-02",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KS",
            "license": "04-49740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.