Individual provider Active NPI

Natalie Duncan, PA-C

  • Physician Assistant
  • Riverside, MO
National Provider Identifier
1265293153
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1805 NW Platte Rd Ste 120
Riverside, MO 64150-7500
Phone
(816) 205-8120
NPI assigned
Jan 18, 2024
Last updated
Aug 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1805 NW Platte Rd Ste 120
Riverside, MO 64150-7500

Mailing address

7300 Ranch Road 2222, BLDG 1, Ste 200
Austin, TX 78730-3255
Phone (512) 628-0465

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240328003136 MO Practitioner - Physician Assistant 1355789140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Creighton University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epiphany Dermatology of Missouri LLCGroup PAC ID 1153689294, 21 clinicians

Practice addresses (Care Compare)

1805 NW Platte Rd
Suite 120
Riverside, MO 64150-7500
Phone (816) 205-8120

2325 Dougherty Ferry Rd
Suite 201
Saint Louis, MO 63122-3356
Phone (314) 993-1714

805 N 36TH St
Suite D
Saint Joseph, MO 64506-2954
Phone (816) 205-8120

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates, Inc. PastSince Dec 31, 1991 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1265293153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 RANCH ROAD 2222, BLDG 1, STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787303255",
            "telephone_number": "512-628-0465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 NW PLATTE RD STE 120",
            "city": "RIVERSIDE",
            "state": "MO",
            "postal_code": "641507500",
            "telephone_number": "816-205-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "NATALIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-18",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, MO

Sources for this page

Verify at the official NPI Registry.