Individual provider Active NPI

Cathanie W Halberstadt, M.D.

  • Obstetrics & Gynecology Physician
  • Lees Summit, MO
National Provider Identifier
1164477170
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
R6N60 Issued in MO
Practice address
20 NE Saint Lukes Blvd
Suite 310
Lees Summit, MO 64086-6001
Phone
(816) 282-7809
Fax
(816) 282-7870
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 04-25211 KS
Obstetrics & Gynecology Physician 207V00000X R6N60 MO Primary

Addresses

Primary practice location

20 NE Saint Lukes Blvd
Suite 310
Lees Summit, MO 64086-6001

Mailing address

20 NE Saint Lukes Blvd
Suite 310
Lees Summit, MO 64086-6001
Phone (816) 282-7809

Other practice location 1

5701 W 119th St Ste 225
Overland Park, KS 66209-3721
Phone (913) 601-4020

Other practice location 2

5701 W 119th St Ste 225
Overland Park, KS 66209-3721
Phone (913) 601-4020

Other identifiers 1

IdentifierTypeStateIssuer
203076419MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060221000538 MO Practitioner - Obstetrics/Gynecology 6002822517 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Goppert - Trinity Family Care, LLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1164477170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 NE SAINT LUKES BLVD",
            "address_2": "SUITE 310",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640866001",
            "telephone_number": "816-282-7809",
            "fax_number": "816-282-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 NE SAINT LUKES BLVD",
            "address_2": "SUITE 310",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640866001",
            "telephone_number": "816-282-7809",
            "fax_number": "816-282-7870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5701 W 119th St Ste 225",
            "address_purpose": "LOCATION",
            "city": "Overland Park",
            "state": "KS",
            "postal_code": "662093721",
            "country_code": "US",
            "telephone_number": "913-601-4020",
            "fax_number": "913-601-4022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5701 W 119th St Ste 225",
            "address_purpose": "LOCATION",
            "city": "Overland Park",
            "state": "KS",
            "postal_code": "662093721",
            "country_code": "US",
            "telephone_number": "913-601-4020",
            "fax_number": "913-601-4022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALBERSTADT",
        "first_name": "CATHANIE",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KS",
            "license": "04-25211",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "R6N60",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203076419",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

Verify at the official NPI Registry.