NPIMap

Individual provider Active NPI

Kevin Paul Huffman, PAC

  • Surgical Physician Assistant
  • Jefferson City, MO
National Provider Identifier
1124122858
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
2012042655 Issued in MO
Practice address
2505 Mission Dr
Suite 200
Jefferson City, MO 65109-9508
Phone
(573) 681-3759
Fax
(573) 681-3659
NPI assigned
Sep 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA03301 TX
Surgical Physician Assistant 363AS0400X 2012042655 MO Primary

Addresses

Primary practice location

2505 Mission Dr
Suite 200
Jefferson City, MO 65109-9508

Mailing address

2505 Mission Dr
Suite 200
Jefferson City, MO 65109-9508
Phone (573) 681-3759

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address khuffman97299@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130313000426 MO Practitioner - Physician Assistant 7315952553 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Regional Health ServicesGroup PAC ID 8921917352, 165 clinicians

Practice addresses (Care Compare)

2505 Mission Dr
Jefferson City, MO 65109-9508

Hospital & facility affiliations

  • SSM Health St. Mary'S Hospital - Jefferson City Hospital, Jefferson City, MO, CCN 260011
  • Lake Regional Health System Hospital, Osage Beach, MO, CCN 260186
  • University of Missouri Health Care Hospital, Columbia, MO, CCN 260141

Merit-based Incentive Payment System (MIPS)

Final score
88.07 of 100Reported as group
Quality
86.39
Promoting interoperability
100
Improvement activities
40
Cost
73.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA03301TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Regional Health Services CurrentSince Sep 2, 2014 Accepting new patients
SSM Regional Health Services CurrentSince Sep 2, 2014 Accepting new patients
SSM Regional Health Services CurrentSince Nov 1, 2023 Accepting new patients
Midland Texas Orthopedic Group Inc Past Accepting new patients
SSM Regional Health Services Past Accepting new patients
West Texas Orthopedics LLP Past Accepting new patients

Locations

7655 Solutions Ctr
Chicago, IL 60677

200 Saint Marys Plz
Ste 301
Jefferson Cty, MO 65101
Phone (573) 634-4212

100 Saint Marys Plz
Jefferson Cty, MO 65101
Phone (573) 635-7642

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1124122858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 MISSION DR",
            "address_2": "SUITE 200",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651099508",
            "telephone_number": "573-681-3759",
            "fax_number": "573-681-3659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 MISSION DR",
            "address_2": "SUITE 200",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651099508",
            "telephone_number": "573-681-3759",
            "fax_number": "573-681-3659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUFFMAN",
        "first_name": "KEVIN",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03301",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": "2012042655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khuffman97299@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "khuffman97299@direct-ehr-ssmhc.com",
            "address_1": "2505 Mission Dr",
            "address_2": "Suite 200",
            "city": "Jefferson City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "651099508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2505 Mission Dr",
            "address_2": "Suite 200",
            "city": "Jefferson City",
            "state": "MO",
            "country_code": "US",
            "postal_code": "651099508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.