Maria K Ittycheri, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

05-53283 Issued in KS

Practice address

9300 Meadow View Dr
Shawnee, KS 66227-7288

Phone

(913) 601-4500

NPI assigned

Apr 6, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

Interoperability endpoints

• Direct secure messaging: mkunnel1004393@ahs.direct-ci.com

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

{
    "created_epoch": "1680739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1104511138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5675 ROE BLVD STE 100",
            "city": "ROELAND PARK",
            "state": "KS",
            "postal_code": "662052538",
            "telephone_number": "913-432-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 MEADOW VIEW DR",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662277288",
            "telephone_number": "913-601-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITTYCHERI",
        "first_name": "MARIA",
        "middle_name": "K",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-06",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "05-53283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Richard Brendan Jackson, LPC, LMAC-T

• Family Medicine Physician in Shawnee, KS
• Providers in Shawnee, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.