Active NPI
Mark H Dewolfe, M.D.
- Hematology & Oncology Physician
- Kansas City, MO
National Provider Identifier
1124021142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- R3A25
- Practice address
- 5400 N Oak Trfy
Suite 101
Kansas City, MO 64118-4688 - Phone
- (816) 454-1658
- Fax
- (816) 454-1734
- NPI assigned
- May 23, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | R3A25 | MO | Primary |
| Hematology & Oncology Physician | 207RH0003X | 04-19790 | KS |
Addresses
Primary practice location
5400 N Oak Trfy
Suite 101
Kansas City, MO 64118-4688
Mailing address
901 E 104TH St
Kansas City, MO 64131-4517
Phone (816) 502-8752
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13192 | Other | MO | COVENTRY |
| 4340992 | Other | MO | AETNA |
| 12440 | Other | MO | HM CARE |
| 2051670901 | Medicaid | KS | |
| 201787405 | Medicaid | MO | |
| 026295099 | Other | MO | FEDERAL BLACK LUNG |
| 09468014 | Other | MO | BCBS OF KANSAS CITY |
| 1001457701 | Other | MO | COMMUNITY HEALTH PLAN |
| 497815 | Other | KS | BCBS OF KANSAS |
| 560391 | Other | MO | FIRSTGUARD |
| 3650047 | Other | MO | UHC |
| 480911591028 | Other | MO | CIGNA |
| 97759 | Other | MO | ADVANTRA MEDICARE REPLACE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-19790 | KS | MD | Hematology & Oncology Physician |
| R3A25 | MO | MD | Hematology & Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kansas City Internal Medicine PA | Past | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
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.
-
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
-
- Internal Medicine Physician
- Overland Park, KS
- NPI 1316969884
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770854400000",
"number": "1124021142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 E 104TH ST",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641314517",
"telephone_number": "816-502-8752",
"fax_number": "816-932-9670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5400 N OAK TRFY",
"address_2": "SUITE 101",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641184688",
"telephone_number": "816-454-1658",
"fax_number": "816-454-1734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEWOLFE",
"first_name": "MARK",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-23",
"last_updated": "2026-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "MO",
"license": "R3A25",
"primary": true
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "KS",
"license": "04-19790",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY",
"identifier": "13192",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4340992",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HM CARE",
"identifier": "12440",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2051670901",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201787405",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL BLACK LUNG",
"identifier": "026295099",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF KANSAS CITY",
"identifier": "09468014",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMUNITY HEALTH PLAN",
"identifier": "1001457701",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF KANSAS",
"identifier": "497815",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRSTGUARD",
"identifier": "560391",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "3650047",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "480911591028",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ADVANTRA MEDICARE REPLACE",
"identifier": "97759",
"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 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.