Individual provider Active NPI

Carl Wesley Fillingame, PA

  • Surgical Physician Assistant
  • Independence, MO
National Provider Identifier
1265971733
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
19550 E 39TH St S Ste 230
Independence, MO 64057-2309
Phone
(816) 795-6630
Fax
(816) 795-6898
NPI assigned
Feb 16, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MO Primary

Addresses

Primary practice location

19550 E 39TH St S Ste 230
Independence, MO 64057-2309

Mailing address

19550 E 39TH St S Ste 230
Independence, MO 64057-2309
Phone (816) 795-6630

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CARL.FILLINGAME@hca2.eclinicaldirectplus.com

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
I20170810002176 MO Practitioner - Physician Assistant 7517238462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Missouri, Kansas City, School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centerpoint Orthopedics, LLCGroup PAC ID 8022107028, 3 clinicians

Practice addresses (Care Compare)

19550 E 39TH St S
Suite 230a
Independence, MO 64057-2358
Phone (816) 795-6630

19600 E 39TH St S
Centerpoint Medical Center
Independence, MO 64057-2301
Phone (816) 276-9230

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as individual
Quality
99.21
Improvement activities
40
Cost
55.49

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Doctors Group, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: carl.fillingame@hca2.eclinicaldirectplus.com

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 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": "1487203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1265971733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19550 E 39TH ST S STE 230",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572309",
            "telephone_number": "816-795-6630",
            "fax_number": "816-795-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19550 E 39TH ST S STE 230",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572309",
            "telephone_number": "816-795-6630",
            "fax_number": "816-795-6898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILLINGAME",
        "first_name": "CARL",
        "middle_name": "WESLEY",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-16",
        "last_updated": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CARL.FILLINGAME@hca2.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "19550 E 39th St S Ste 230",
            "city": "Independence",
            "state": "MO",
            "country_code": "US",
            "postal_code": "640572309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.