NPIMap

Organization Active NPI

Kansas City Kidney Specialists

Doing business as Kansas City Kidney Specialist

  • Nephrology Physician
  • Overland Park, KS
National Provider Identifier
1174016729
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
04-37625 Issued in KS
Legal business name
KANSAS CITY KIDNEY SPECIALISTS
Doing business as
Kansas City Kidney Specialist
Practice address
11661 College Blvd
Overland Park, KS 66210
Phone
(913) 495-5517
Fax
(913) 495-5518
NPI assigned
Jun 8, 2018
Last updated
Aug 22, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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

Authorized official

Name
Dr. Tarek Darwish, MDNPI 1790712750
Title
Physician
Phone
(913) 495-5517

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 Physician 207RN0300X 04-37625 KS Primary

Addresses

Primary practice location

11661 College Blvd
Overland Park, KS 66210

Mailing address

12705 W 161St St Ste 210
Overland Park, KS 66221-8641
Phone (913) 495-5517

Other identifiers 3

IdentifierTypeStateIssuer
1790712750OtherINDIVIDUAL NPI
04-37625OtherKSNEPHROLOGY
0437625OtherKSSTATE MEDICAL LICENSE

Other names 1

  • Kansas City Kidney Specialist Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180817001153 KS Part B Supplier - Clinic/Group Practice 9739438110 Receives reassigned benefits from 9 practitioners
Practice locations: Overland Park, KS
O20221230001964 MO Part B Supplier - Clinic/Group Practice 9739438110 Receives reassigned benefits from 1 practitioner
Practice locations: Grandview, MO

National Provider Directory

National Provider Directory

Locations

11661 College Blvd
Ste 100
Overland Park, KS 66210
Phone (913) 495-5517

Practitioners & affiliated clinicians

Practitioners 9

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": "1528416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534896000000",
    "number": "1174016729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12705 W 161ST ST STE 210",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662218641",
            "telephone_number": "913-495-5517",
            "fax_number": "913-495-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11661 COLLEGE BLVD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66210",
            "telephone_number": "913-495-5517",
            "fax_number": "913-495-5518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANSAS CITY KIDNEY SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-08",
        "last_updated": "2018-08-22",
        "status": "A",
        "authorized_official_last_name": "DARWISH",
        "authorized_official_first_name": "TAREK",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "913-495-5517",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "KS",
            "license": "04-37625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1790712750",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEPHROLOGY",
            "identifier": "04-37625",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "0437625",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kansas City Kidney Specialist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; 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.