NPIMap

Individual provider Active NPI

Christian A Hettinger, M.D.

  • Urology Physician
  • Overland Park, KS
National Provider Identifier
1245249044
Registry record updated Sep 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
04-34552 Issued in KS
Practice address
10701 Nall Ave Ste 100
Overland Park, KS 66211-1244
Phone
(913) 338-5585
Fax
(913) 338-3229
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 2010024966 MO
Urology Physician 208800000X 04-34552 KS Primary

Addresses

Primary practice location

10701 Nall Ave Ste 100
Overland Park, KS 66211-1244

Mailing address

10701 Nall Ave Ste 100
Overland Park, KS 66211-1244
Phone (913) 338-5585

Other identifiers 2

IdentifierTypeStateIssuer
44580011OtherBCBS KC
P00893060OtherRR PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100902000448 MO Practitioner - Urology 0749284776 Reassigns benefits to 1 organization
I20100916001002 KS Practitioner - Urology 0749284776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Tennessee, HSC, College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas City Urology Care PAGroup PAC ID 9032006853, 71 clinicians

Practice addresses (Care Compare)

10701 Nall Ave
Suite 100
Overland Park, KS 66211-1244
Phone (913) 341-7985

301 NE Mulberry St
Suite 200
Lees Summit, MO 64086-6017
Phone (816) 524-1007

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection19
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-34552KSMDUrology Physician
2010024966MOMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke's Physician Group Inc PastSince Aug 2, 2010 Accepting new patients

Organizations & group practices 2

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1245249044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10701 NALL AVE STE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111244",
            "telephone_number": "913-338-5585",
            "fax_number": "913-338-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 NALL AVE STE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111244",
            "telephone_number": "913-338-5585",
            "fax_number": "913-338-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETTINGER",
        "first_name": "CHRISTIAN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MO",
            "license": "2010024966",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "KS",
            "license": "04-34552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KC",
            "identifier": "44580011",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR PIN",
            "identifier": "P00893060",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.