Individual provider Active NPI

Nicholas Mannebach, DO

  • Emergency Medicine Physician
  • Kansas City, KS
National Provider Identifier
1265069173
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2023007521 Issued in MO
Practice address
4000 Cambridge St
Kansas City, KS 66160-8501
Phone
(913) 588-1227
NPI assigned
Mar 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2023007521 MO Primary

Addresses

Primary practice location

4000 Cambridge St
Kansas City, KS 66160-8501

Mailing address

711 W 38TH St Apt 1
Kansas City, MO 64111-2950

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240109002590 MO Practitioner - Emergency Medicine 1052735115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Services of Mo LLCGroup PAC ID 1951766559, 85 clinicians

Practice addresses (Care Compare)

19600 E 39TH St S
Centerpoint Medical Center
Independence, MO 64057-2301
Phone (816) 698-7000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of Mo, LLC Emergency Medicine CurrentSince Nov 5, 2023 Accepting new patients

Locations

19600 E 39th St S
Independence, MO 64057
Phone (816) 698-7000

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 1

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 1

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": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1265069173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 W 38TH ST APT 1",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641112950"
        },
        {
            "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": [],
    "basic": {
        "last_name": "MANNEBACH",
        "first_name": "NICHOLAS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-23",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2023007521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.