NPIMap

Organization Active NPI

Midwest Medical Specialists PA

  • Dermatology Physician
  • Kansas City, MO
National Provider Identifier
1043316250
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
MIDWEST MEDICAL SPECIALISTS PA
Practice address
5330 N Oak Trfy
Suite 201
Kansas City, MO 64118-4699
Phone
(816) 454-0666
Fax
(816) 454-1694
NPI assigned
Sep 15, 2006
Last updated
Feb 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Authorized official

Name
Frank C Koranda, MDNPI 1871560045
Title
MD
Phone
(816) 454-0666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

5330 N Oak Trfy
Suite 201
Kansas City, MO 64118-4699

Mailing address

5330 N Oak Trfy
Suite 201
Kansas City, MO 64118-4699
Phone (816) 454-0666

Other practice location 1

124 Westwoods Dr
Liberty, MO 64068-1181
Phone (816) 464-0666

Other identifiers 1

IdentifierTypeStateIssuer
CI8219OtherMORAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040109000731 MO Part B Supplier - Clinic/Group Practice 7517867203 Receives reassigned benefits from 12 practitioners
Practice locations: Kansas City, MO; Liberty, MO

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D0902969Midwest Medical Specialists, PA5330 N Oak Trafficway Ste 201, Kansas City, MO 64118ComplianceMay 16, 2027
26D2232297Midwest Medical Specialists124 Westwoods Dr, Liberty, MO 64068Certificate of waiverAug 11, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740096000000",
    "number": "1043316250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5330 N OAK TRFY",
            "address_2": "SUITE 201",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641184699",
            "telephone_number": "816-454-0666",
            "fax_number": "816-454-1694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 N OAK TRFY",
            "address_2": "SUITE 201",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641184699",
            "telephone_number": "816-454-0666",
            "fax_number": "816-454-1694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "124 Westwoods Dr",
            "address_purpose": "LOCATION",
            "city": "Liberty",
            "state": "MO",
            "postal_code": "640681181",
            "country_code": "US",
            "telephone_number": "816-464-0666",
            "fax_number": "816-559-7118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDWEST MEDICAL SPECIALISTS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A",
        "authorized_official_last_name": "KORANDA",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "816-454-0666",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI8219",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.