Individual provider Active NPI

Kidist Daka

  • Adult Health Clinical Nurse Specialist
  • Kansas City, KS
National Provider Identifier
1275307936
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
53-82667-072 Issued in KS
Practice address
2000 Olathe FL 5
Kansas City, KS 66160-8505
Phone
(913) 588-6022
NPI assigned
Nov 13, 2023
Last updated
Nov 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 53-82667-072 KS Primary
Chronic Care Clinical Nurse Specialist 364SC2300X 53-82667-072 KS

Addresses

Primary practice location

2000 Olathe FL 5
Kansas City, KS 66160-8505

Mailing address

12501 Benson St
Overland Park, KS 66213-1791
Phone (913) 638-0021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20240108000723 KS Practitioner - Certified Clinical Nurse Specialist (CNS) 9537510250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians

Practice addresses (Care Compare)

11300 Corporate Ave
Suite 342
Lenexa, KS 66219-1368

20375 W 151St St
Olathe, KS 66160-0001
Phone (913) 588-1227

3901 Rainbow Blvd
Kansas City, KS 66160-0001
Phone (913) 588-7775

3901 Rainbow Blvd
Kansas City, KS 66160-8500
Phone (913) 588-7013

4000 Cambridge St
Kansas City, KS 66160-0001
Phone (913) 588-1227

4000 Cambridge St
Kansas City, KS 66160-8500

4000 Cambridge St
Suite G600
Kansas City, KS 66160-8501
Phone (913) 588-1227

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-82667-072KSMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc Current Accepting new patients
Kansas University Physicians Inc CurrentSince Dec 28, 2023 Accepting new patients
Kansas University Physicians Inc CurrentSince Dec 28, 2023 Accepting new patients

Locations

2000 Olathe
Fl 5
Kansas City, KS 66160
Phone (913) 588-6022

3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005

11300 Corporate Ave
Ste 342
Lenexa, KS 66219
Phone (913) 574-0425

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1699833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1275307936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 BENSON ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662131791",
            "telephone_number": "913-638-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 OLATHE FL 5",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608505",
            "telephone_number": "913-588-6022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAKA",
        "first_name": "KIDIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-13",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "KS",
            "license": "53-82667-072",
            "primary": true
        },
        {
            "code": "364SC2300X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Chronic Care",
            "state": "KS",
            "license": "53-82667-072",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.