Individual provider Active NPI

Elisabeth Skariah, APRN

  • Family Nurse Practitioner
  • Overland Park, KS
National Provider Identifier
1134524887
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-76501-012 Issued in KS
Practice address
12290 College Blvd
Overland Park, KS 66210-4049
Phone
(913) 327-1332
NPI assigned
Oct 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 53-76501-012 KS Primary

Addresses

Primary practice location

12290 College Blvd
Overland Park, KS 66210-4049

Mailing address

12290 College Blvd
Overland Park, KS 66210-4049
Phone (913) 327-1332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141208000243 KS Practitioner - Nurse Practitioner 4385966019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minuteclinic Diagnostic of Kansas PAGroup PAC ID 7416043807, 139 clinicians

Practice addresses (Care Compare)

11729 Roe Ave
Leawood, KS 66211-2605
Phone (800) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
53-76501-012KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Kansas PA Family CurrentSince Nov 17, 2014 Accepting new patients

Locations

18351 W 119th St
Olathe, KS 66061
Phone (913) 393-7325

12290 College Blvd
Overland Park, KS 66210
Phone (913) 327-1332

11729 Roe Ave
Shawnee Mission, KS 66211
Phone (877) 646-2546

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1134524887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12290 COLLEGE BLVD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662104049",
            "telephone_number": "913-327-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12290 COLLEGE BLVD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662104049",
            "telephone_number": "913-327-1332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKARIAH",
        "first_name": "ELISABETH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-23",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-76501-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.