NPIMap

Individual provider Active NPI

Todd E Fristo, MD

  • Family Medicine Physician
  • Independence, MO
National Provider Identifier
1265427348
Registry record updated Jan 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD R9J78 Issued in MO
Practice address
4801 S Cliff Ave
Ste. 300
Independence, MO 64055-7015
Phone
(816) 251-5200
Fax
(816) 251-5299
NPI assigned
Sep 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD R9J78 MO Primary

Addresses

Primary practice location

4801 S Cliff Ave
Ste. 300
Independence, MO 64055-7015

Mailing address

901 E. 104TH St.
Mailstop 400N
Kansas City, MO 64131
Phone (816) 502-7104

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040616000755 MO Practitioner - Family Practice 3577547603 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

20 NE Saint Lukes Blvd
Lee's Summit, MO 64086-6001

301 NE Rice Rd
Lees Summit, MO 64086-2979
Phone (816) 251-5760

310 SW Ward Rd
Lees Summit, MO 64081-2445
Phone (816) 251-5770

4801 S Cliff Ave
Suite 300
Independence, MO 64055-6954
Phone (816) 251-5200

601 S 169 Hwy
Smithville, MO 64089-9317
Phone (816) 532-3700

601 S US Hwy 169
Smithville, MO 64089-9317
Phone (816) 532-3999

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD R9J78MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Specialist of Lee's Summit, LLC Family Medicine CurrentSince Mar 1, 2004 Accepting new patients
Saint Luke's Physician Group Inc Family Medicine CurrentSince Mar 1, 2017 Accepting new patients
State Line Medical Group LLC Past Accepting new patients

Locations

4801 S Cliff Ave
Ste 300
Independence, MO 64055
Phone (816) 251-5200

901 E 104th St
Kansas City, MO 64131
Phone (816) 502-7117

901 E 104th St
#400N
Kansas City, MO 64131
Phone (816) 502-8756

2100 SE Blue Pkwy
Lees Summit, MO 64063
Phone (816) 282-5175

301 NE Mulberry St
Ste 202
Lees Summit, MO 64086
Phone (816) 251-5710

1301 SW Arborwalk Blvd
#A
Lees Summit, MO 64082
Phone (816) 537-6232

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

403 Burkarth Rd
Warrensburg, MO 64093
Phone (660) 474-2500

Interoperability endpoints

  • Direct secure messaging: tfristo67232@direct.saint-lukes.org

Organizations & group practices 3

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 11

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": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516320000000",
    "number": "1265427348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E. 104TH ST.",
            "address_2": "MAILSTOP 400N",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64131",
            "telephone_number": "816-502-7104",
            "fax_number": "816-932-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 S CLIFF AVE",
            "address_2": "STE. 300",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640557015",
            "telephone_number": "816-251-5200",
            "fax_number": "816-251-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRISTO",
        "first_name": "TODD",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2018-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "MD R9J78",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.