Active NPI
Soroush Ershadifar
- Otolaryngology Physician
- Kansas City, KS
National Provider Identifier
1184327603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 94-12425
- Practice address
- 3901 Rainbow Blvd # Ms 3010
Kansas City, KS 66160-2200 - Phone
- (925) 800-9541
- NPI assigned
- Mar 23, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 94-12425 | KS | Primary |
Addresses
Primary practice location
3901 Rainbow Blvd # Ms 3010
Kansas City, KS 66160-2200
Mailing address
4610 X St
Sacramento, CA 95817-2200
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250627003160 | KS | Order and Referring Only - Otolaryngology | 7214440700 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750550400000",
"number": "1184327603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4610 X ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958172200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 RAINBOW BLVD # MS 3010",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "661602200",
"telephone_number": "925-800-9541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERSHADIFAR",
"first_name": "SOROUSH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-23",
"last_updated": "2025-06-22",
"certification_date": "2025-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "KS",
"license": "94-12425",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.