NPIMap

Individual provider Active NPI

Kelly J Hendricks, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Overland Park, KS
National Provider Identifier
1043329147
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
04-30708 Issued in KS
Practice address
5701 W 119TH St Ste 410
Overland Park, KS 66209-3721
Phone
(913) 345-6901
Fax
(913) 469-4095
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 04-30708 KS
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 04-30708 KS Primary

Addresses

Primary practice location

5701 W 119TH St Ste 410
Overland Park, KS 66209-3721

Mailing address

5701 W 119TH St Ste 410
Overland Park, KS 66209-3721
Phone (913) 345-6901

Other identifiers 5

IdentifierTypeStateIssuer
200265840AMedicaidKS
34266011OtherMOBCBS
580580OtherKSFIRSTGUARD
209281302MedicaidMO
P00154501OtherRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address KELLY.HENDRICKS@hca2.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100913000057 KS Practitioner - Orthopedic Surgery 6709852254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Nebraska College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Menorah Medical Group LLCGroup PAC ID 1355535162, 21 clinicians

Practice addresses (Care Compare)

5701 W 119TH St
410 Kansas City Joint Replacement
Overland Park, KS 66209-3721
Phone (913) 345-6901

Hospital & facility affiliations

  • Amedisys Home Health of Missouri Home health agency, Lees Summit, MO, CCN 267623
  • HCA Midwest Healthcare at Home Home health agency, Overland Park, KS, CCN 178085
  • Centerwell Home Health Home health agency, Overland Park, KS, CCN 177179
  • Ahc Home Health of Kansas City Dba Advanced Home Health Care Home health agency, Overland Park, KS, CCN 178106
  • Specialized Home Care Home health agency, Overland Park, KS, CCN 178122
  • Menorah Medical Center Hospital, Overland Park, KS, CCN 170182
  • Kansas City Orthopaedic Institute Hospital, Leawood, KS, CCN 170188
  • University of Kansas Hospital Hospital, Kansas City, KS, CCN 170040
  • Adventhealth Shawnee Mission Hospital, Shawnee Mission, KS, CCN 170104
  • LMH Hospital, Lawrence, KS, CCN 170137

Merit-based Incentive Payment System (MIPS)

Final score
86.51 of 100Reported as individual
Quality
78.53
Promoting interoperability
100
Improvement activities
40
Cost
76.5

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement70
Knee replacement81
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-30708KSMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Menorah Medical Group, LLC CurrentSince Aug 29, 2017 Accepting new patients
Menorah Medical Group, LLC Orthopaedic Surgery Past Accepting new patients

Locations

5701 W 119th St
Ste 410
Overland Park, KS 66209
Phone (913) 345-3650

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 and National Provider Directory roles.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1043329147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 W 119TH ST STE 410",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662093721",
            "telephone_number": "913-345-6901",
            "fax_number": "913-469-4095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 W 119TH ST STE 410",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662093721",
            "telephone_number": "913-345-6901",
            "fax_number": "913-469-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "KELLY",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "KS",
            "license": "04-30708",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "KS",
            "license": "04-30708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200265840A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "34266011",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTGUARD",
            "identifier": "580580",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209281302",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00154501",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KELLY.HENDRICKS@hca2.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "5701 W 119th St Ste 410",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662093721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.