NPIMap

Organization Active NPI

Midwest Psychiatric PA

Doing business as Awakenings

  • Psychiatry Physician
  • Prairie Village, KS
National Provider Identifier
1154535060
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0427007 Issued in KS
Legal business name
MIDWEST PSYCHIATRIC PA
Doing business as
Awakenings
Practice address
5300 W 94TH Ter Ste 200
Prairie Village, KS 66207-2536
Phone
(913) 381-8555
Fax
(913) 677-2112
NPI assigned
May 9, 2007
Last updated
Aug 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Authorized official

Name
Magdalen Gustilo
Title
Director of Payer Relations
Phone
(714) 568-7667

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU
Psychiatry Physician 2084P0800X 0427007 KS Primary
Addiction Psychiatry Physician 2084P0802X 0427007 KS

Addresses

Primary practice location

5300 W 94TH Ter Ste 200
Prairie Village, KS 66207-2536

Mailing address

5300 W 94TH Ter Ste 200
Prairie Village, KS 66207-2536
Phone (913) 381-8555

Other identifiers 2

IdentifierTypeStateIssuer
203768908-AMedicaidMO
100384540BMedicaidKS

Other names 1

  • Awakenings Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130523000701 KS Part B Supplier - Clinic/Group Practice 7810135209 Receives reassigned benefits from 6 practitioners
Practice locations: Prairie Village, KS

National Provider Directory

National Provider Directory

Locations

5300 W 94th Ter
Ste 200
Prairie Village, KS 66207
Phone (913) 381-8555

4200 Somerset Dr
Ste 214
Prairie Vlg, KS 66208
Phone (913) 488-8160

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787702400000",
    "number": "1154535060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 W 94TH TER STE 200",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662072536",
            "telephone_number": "913-381-8555",
            "fax_number": "913-677-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 W 94TH TER STE 200",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662072536",
            "telephone_number": "913-381-8555",
            "fax_number": "913-677-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST PSYCHIATRIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A",
        "authorized_official_last_name": "GUSTILO",
        "authorized_official_first_name": "MAGDALEN",
        "authorized_official_title_or_position": "DIRECTOR OF PAYER RELATIONS",
        "authorized_official_telephone_number": "714-568-7667"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KS",
            "license": "0427007",
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "KS",
            "license": "0427007",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203768908-A",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100384540B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Awakenings",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prairie Village, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.