Organization Active NPI

Motus Biologics and Sports Medicine LLC

  • Sports Medicine (Family Medicine) Physician
  • Overland Park, KS
National Provider Identifier
1215388632
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
04-36559 Issued in KS
Legal business name
MOTUS BIOLOGICS AND SPORTS MEDICINE LLC
Practice address
5525 W 119TH St
Ste 250
Overland Park, KS 66209-3724
Phone
(913) 808-5275
Fax
(913) 257-5150
NPI assigned
Jun 27, 2016
Last updated
Mar 23, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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

Authorized official

Name
Dr. Leslie A Michaud, M.D.NPI 1972701019
Title
Owner
Phone
(913) 808-5275

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 04-36559 KS Primary
Ambulatory Surgical Clinic/Center 261QA1903X 04-36559 KS

Addresses

Primary practice location

5525 W 119TH St
Ste 250
Overland Park, KS 66209-3724

Mailing address

5525 W 119TH St
Ste 250
Overland Park, KS 66209-3724
Phone (913) 808-5275

Other identifiers 1

IdentifierTypeStateIssuer
108000021OtherPTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170405001972 KS Part B Supplier - Clinic/Group Practice 8123304136 Receives reassigned benefits from 1 practitioner
Practice locations: Overland Park, KS

National Provider Directory

National Provider Directory

Locations

5525 W 119th St
Ste 250
Overland Park, KS 66209
Phone (913) 808-5275

Practitioners & affiliated clinicians

Practitioners 1

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": "1466985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490227200000",
    "number": "1215388632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 W 119TH ST",
            "address_2": "STE 250",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662093724",
            "telephone_number": "913-808-5275",
            "fax_number": "913-257-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 W 119TH ST",
            "address_2": "STE 250",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662093724",
            "telephone_number": "913-808-5275",
            "fax_number": "913-257-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOTUS BIOLOGICS AND SPORTS MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-27",
        "last_updated": "2017-03-23",
        "status": "A",
        "authorized_official_last_name": "MICHAUD",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-808-5275",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "KS",
            "license": "04-36559",
            "primary": true
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "KS",
            "license": "04-36559",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "108000021",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Mar 23, 2017; 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.