NPIMap

Organization Active NPI

Kansas City Kidney Consultants, PA

  • Nephrology Physician
  • Kansas City, MO
National Provider Identifier
1164528626
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
KANSAS CITY KIDNEY CONSULTANTS, PA
Practice address
4601 Madison Ave Ste 300
Kansas City, MO 64112-1268
Phone
(816) 531-0552
Fax
(816) 756-2503
NPI assigned
Sep 15, 2006
Reactivated
May 5, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Authorized official

Name
Dr. Ryan M Lustig, M.D.NPI 1124246335
Title
President
Phone
(816) 531-0552

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

4601 Madison Ave Ste 300
Kansas City, MO 64112-1268

Mailing address

4601 Madison Ave Ste 300
Kansas City, MO 64112-1268
Phone (816) 531-0552

Other practice location 1

100 NE Missouri Rd Ste 204
Lees Summit, MO 64086-4716
Phone (816) 531-0552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040811000252 MO Part B Supplier - Clinic/Group Practice 2769454644 Receives reassigned benefits from 24 practitioners
Practice locations: Lees Summit, MO; Kansas City, MO; Butler, MO; Grandview, MO; Independence, MO; Harrisonville, MO
O20180103000540 KS Part B Supplier - Clinic/Group Practice 2769454644 Receives reassigned benefits from 22 practitioners
Practice locations: Overland Park, KS; Pittsburg, KS; Kansas City, KS

National Provider Directory

National Provider Directory

Locations

6740 W 121st St
#150
Overland Park, KS 66209

6740 W 121st St
Overland Park, KS 66209
Phone (913) 894-6500

19101 E Valley View Pkwy
Ste E
Independence, MO 64055
Phone (816) 795-6018

8608 E 63rd St
Kansas City, MO 64133
Phone (816) 353-6100

100 Missouri Ave
Ste 204
Kansas City, MO 64106

100 NE Missouri Rd
Lees Summit, MO 64086
Phone (816) 524-3312

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788220800000",
    "number": "1164528626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 MADISON AVE STE 300",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641121268",
            "telephone_number": "816-531-0552",
            "fax_number": "816-756-2503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 MADISON AVE STE 300",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641121268",
            "telephone_number": "816-531-0552",
            "fax_number": "816-756-2503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 NE Missouri Rd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Lees Summit",
            "state": "MO",
            "postal_code": "640864716",
            "country_code": "US",
            "telephone_number": "816-531-0552",
            "fax_number": "816-756-2503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KANSAS CITY KIDNEY CONSULTANTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "deactivation_date": "2022-04-12",
        "reactivation_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "LUSTIG",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-531-0552",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.