Maniza W Ehtesham, MD
Individual provider Active NPI Internal Medicine Physician · Kansas City, MO
NPI 1124052386 · NPPES record last updated Jun 3, 2016
Key facts
- NPI
- 1124052386
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 2006019748 (MO)
- Practice address
- 2301 Holmes St
Kansas City, MO 64108-2640 - Phone
- (816) 404-1000
- NPI assigned
- Jul 11, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
8901 W 74TH St
Overland Park, KS 66204-2204
Phone (913) 662-1085
Hospital & facility affiliations
- Phoenix Home Care and Hospice
- Adventhealth Shawnee Mission
Merit-based Incentive Payment System (MIPS)
- Final score
- 18 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 60
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140517000137 | KS | Practitioner - Internal Medicine | 6204830631 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006019748 | MO | MD | Sleep Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kansas Hospitalist Services PA | Current |
Accepting new patients | |
| Inpatient Consultants of Kansas PA | Internal Medicine | Current |
Accepting new patients |
| A4Me, Professional Association | Current |
Accepting new patients | |
| Inpatient Consultants of Kansas PA | Internal Medicine | Current |
Accepting new patients |
| Shawnee Mission Medical Center Inc | Past | Accepting new patients |
Locations
10640 W 87th St
Overland Park, KS 66214
Phone (913) 888-0777
10500 Quivira Rd
Shawnee Mission, KS 66215
Phone (913) 227-0565
9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230
2301 Holmes St
Kansas City, MO 64108
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2006019748 | MO | Yes |
| Sleep Medicine (Internal Medicine) Physician | 207RS0012X | 2006019748 | MO |
Addresses
Primary practice location
2301 Holmes St
Kansas City, MO 64108-2640
Mailing address
8901 W 74TH St
Ste 800
Overland Park, KS 66204-2204
Phone (816) 218-2500
Other providers in Kansas City, MO
- Caryn Joy Ehrenberger
- Emily Ehresman
- Daniel G Ehrich
- Rebecca C Ehrich
- Zarmina Ehsan
- Ashley Ann Eichelberger
- Eichenauer MD LLC
- Stefan Eichenauer
- Paige Eicher
- Lynn Lee Eickhoff
All providers in Kansas City, MO · Internal Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.