Individual provider Active NPI

Benjamin Thomas Sundling

  • Emergency Medicine Physician
  • Shawnee Mission, KS
National Provider Identifier
1063831964
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
05-40859 Issued in KS
Practice address
9100 W 74TH St
Shawnee Mission, KS 66204
Phone
(913) 676-2214
NPI assigned
Apr 8, 2014
Last updated
Jun 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 05-40859 KS Primary

Addresses

Primary practice location

9100 W 74TH St
Shawnee Mission, KS 66204

Mailing address

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

Other practice location 1

1505 W Sherman Ave
Vineland, NJ 08360-6912
Phone (856) 641-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 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

Enrollment IDStateProvider typePAC IDDetails
I20180712002601 KS Practitioner - Emergency Medicine 3274891486 Reassigns benefits to 1 organization
I20220902002239 MO Practitioner - Emergency Medicine 3274891486 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

130 E Lockling St
Brookfield, MO 64628-2337
Phone (660) 258-1278

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05-40859KSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harrison County Community Hospital District Current Accepting new patients
Saint Lukes Hospital of Chillicothe Emergency Medicine CurrentSince Jul 26, 2022 Accepting new patients
General John J Pershing Memorial Hospital Association CurrentSince Jun 1, 2023 Accepting new patients
Saint Luke's Hospital of Trenton Current Accepting new patients
Saint Luke's Hospital of Trenton Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
Saint Lukes Hospital of Chillicothe CurrentSince Jul 26, 2022 Accepting new patients
Saint Luke's Hospital of Trenton CurrentSince Aug 1, 2022 Accepting new patients
General John J Pershing Memorial Hospital Association CurrentSince Jun 1, 2023 Accepting new patients
Inspira Health Network Medical Group, P.C. Past Accepting new patients

Locations

2600 Miller St
Bethany, MO 64424
Phone (660) 425-0253

130 E Lockling St
Brookfield, MO 64628
Phone (660) 258-1050

2799 N Washington St
Chillicothe, MO 64601
Phone (660) 214-8300

191 Iowa Blvd
Trenton, MO 64683
Phone (660) 358-5700

Interoperability endpoints

  • FHIR API: https://epicmobile.corp.saint-lukes.org/FHIRPROXY/api/FHIR/R4

Organizations & group practices 10

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 2

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": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1063831964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9100 W 74TH ST",
            "city": "SHAWNEE MISSION",
            "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": "9100 W 74TH ST",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "66204",
            "telephone_number": "913-676-2214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1505 W Sherman Ave",
            "address_purpose": "LOCATION",
            "city": "Vineland",
            "state": "NJ",
            "postal_code": "083606912",
            "country_code": "US",
            "telephone_number": "856-641-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUNDLING",
        "first_name": "BENJAMIN",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-08",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KS",
            "license": "05-40859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee Mission, KS

Sources for this page

Verify at the official NPI Registry.