Active NPI
Carl Dubose, M.D.
- Psychiatry Physician
- Kansas City, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 2017014862
- Practice address
- 4400 Broadway Ste 407
Kansas City, MO 64111 - Phone
- (816) 931-1711
- Fax
- (816) 932-1719
- NPI assigned
- Mar 31, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | 2017014862 | MO | Primary |
Addresses
Primary practice location
4400 Broadway Ste 407
Kansas City, MO 64111
Mailing address
901 E 104TH St
Mailstop 400S
Kansas City, MO 64131
Phone (816) 502-7117
Other practice location 1
1000 E 24th St
Kansas City, MO 64108-2776
Phone (816) 512-7481
Other practice location 2
1000 E 24th St
Kansas City, MO 64108-2776
Phone (816) 512-7481
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
4400 Broadway
Suite 505
Kansas City, MO 64111-3498
Phone (816) 932-4802
4400 Broadway
Suite 520
Kansas City, MO 64111-3342
Phone (816) 531-4080
4400 Broadway Blvd
Kansas City, MO 64111-3342
4400 Broadway Blvd
Suite 104
Kansas City, MO 64111-3498
Phone (816) 932-3100
4401 Wornall Rd
Kansas City, MO 64111-3220
Phone (816) 932-3100
601 S 169 Hwy
Smithville, MO 64089-9317
Phone (816) 532-3700
601 S US Hwy 169
Smithville, MO 64089-9317
Phone (816) 532-3999
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.56 of 100
- Quality
- 76.07
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 65.79
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017014862 | MO | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Luke'S Physician Group Inc | Current | Accepting new patients | |
| Saint Lukes Physician Group II LLC | Past | Accepting new patients |
Locations
901 E 104th St
#400S
Kansas City, MO 64131
Phone (816) 502-7117
4400 Broadway Blvd
Ste 407
Kansas City, MO 64111
Phone (816) 931-1711
5844 NW Barry Rd
Ste 110
Kansas City, MO 64154
Phone (816) 880-6100
601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999
Interoperability endpoints
- cdubose216856@direct.saint-lukes.org
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.
-
- Family Medicine Physician
- Kansas City, MO
- NPI 1093263717
-
- Surgery Physician
- Kansas City, MO
- NPI 1750335337
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Kansas City, MO
- NPI 1063494177
-
- General Acute Care Hospital
- Kansas City, MO
- NPI 1932642972
-
- General Acute Care Hospital
- Liberty, MO
- NPI 1275926198
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535414400000",
"number": "1114345840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 E 104TH ST",
"address_2": "MAILSTOP 400S",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "64131",
"telephone_number": "816-502-7117",
"fax_number": "816-932-9670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 BROADWAY STE 407",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "64111",
"telephone_number": "816-931-1711",
"fax_number": "816-932-1719"
}
],
"practiceLocations": [
{
"address_1": "1000 E 24th St",
"address_purpose": "LOCATION",
"city": "Kansas City",
"state": "MO",
"postal_code": "641082776",
"country_code": "US",
"telephone_number": "816-512-7481",
"fax_number": "816-512-7486",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1000 E 24th St",
"address_purpose": "LOCATION",
"city": "Kansas City",
"state": "MO",
"postal_code": "641082776",
"country_code": "US",
"telephone_number": "816-512-7481",
"fax_number": "816-512-7486",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DUBOSE",
"first_name": "CARL",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-03-31",
"last_updated": "2018-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MO",
"license": "2017014862",
"primary": true
}
],
"identifiers": [],
"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 Aug 28, 2018; 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.
- 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.