Individual provider Active NPI

Samuel Peter Nitka, PA-C

  • Physician Assistant
  • Kansas City, KS
National Provider Identifier
1225689177
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15-03178
Practice address
4000 Cambridge St
Kansas City, KS 66160-8501
Phone
(913) 588-1227
NPI assigned
Sep 23, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2025017995 MO
Physician Assistant 363A00000X 15-03178 Primary

Addresses

Primary practice location

4000 Cambridge St
Kansas City, KS 66160-8501

Mailing address

1016 NE Queens CT
Lees Summit, MO 64064-1770

Other practice location 1

4401 Wornall Rd
Kansas City, MO 64111-3220
Phone (816) 932-2000

Other practice location 2

20333 W 151st St
Olathe, KS 66061-5350
Phone (913) 588-1227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, KS2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221221000893 VA Practitioner - Physician Assistant 3274914189 Reassigns benefits to 1 organization
I20251224001266 KS Practitioner - Physician Assistant 3274914189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4000 Cambridge St
Kansas City, KS 66160-0001
Phone (913) 588-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.6 of 100Reported as group
Quality
76.36
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. CurrentSince Dec 1, 2022 Accepting new patients
University of Kansas Hospital Authority CurrentSince Dec 18, 2025 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Dec 1, 2022 Accepting new patients
University of Kansas Hospital Authority CurrentSince Dec 18, 2025 Accepting new patients

Locations

3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005

4000 Cambridge St
Kansas City, KS 66160
Phone (913) 588-0000

12300 Metcalf Ave
Shawnee Mission, KS 66213
Phone (913) 317-7000

4401 Wornall Rd
Kansas City, MO 64111
Phone (816) 932-2107

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

Organizations & group practices 5

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1225689177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 NE QUEENS CT",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640641770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 CAMBRIDGE ST",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608501",
            "telephone_number": "913-588-1227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4401 Wornall Rd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641113220",
            "country_code": "US",
            "telephone_number": "816-932-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20333 W 151st St",
            "address_purpose": "LOCATION",
            "city": "Olathe",
            "state": "KS",
            "postal_code": "660615350",
            "country_code": "US",
            "telephone_number": "913-588-1227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NITKA",
        "first_name": "SAMUEL",
        "middle_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-23",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2025017995",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "15-03178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.