NPIMap

Individual provider Active NPI

Marija Tonkovic-Capin, MD

  • Multi-Specialty Group
  • Cameron, MO
National Provider Identifier
1275731010
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty GroupTaxonomy code 193200000X
License
2011006615 Issued in MO
Practice address
1600 E Evergreen St
Cameron, MO 64429-2400
Phone
(816) 649-3208
Fax
(816) 649-3204
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 2011006615 MO
Multi-Specialty Group 193200000X 2011006615 MO Primary
Multi-Specialty Group 193200000X 94-06648 KS

Addresses

Primary practice location

1600 E Evergreen St
Cameron, MO 64429-2400

Mailing address

1600 E Evergreen St
Cameron, MO 64429-2400
Phone (816) 649-3208

Other identifiers 1

IdentifierTypeStateIssuer
1275731010MedicaidMO

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
I20110926000873 MO Practitioner - Dermatology 7416128319 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1600 E Evergreen St
Cameron, MO 64429-2400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision16
Removal of skin lesions400
Removal or shaving of skin growth51
Skin biopsy74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
94-06648KSMDMulti-Specialty Group
2011006615MOMDMulti-Specialty Group

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Valley Memorial Hospital District CurrentSince Oct 6, 2017 Accepting new patients
Golden Valley Memorial Hospital District Multi-Specialty Current Accepting new patients
Golden Valley Memorial Hospital District CurrentSince Oct 6, 2017 Accepting new patients
Cass Regional Medical Center Multi-Specialty CurrentSince Aug 16, 2011 Accepting new patients
Cameron Regional Medical Center, Inc. Multi-Specialty CurrentSince Aug 3, 2011 Accepting new patients
Cass Regional Medical Center CurrentSince Aug 16, 2011 Accepting new patients
Cameron Regional Medical Center Inc Multi-Specialty CurrentSince Aug 3, 2011 Accepting new patients

Locations

1600 E Evergreen St
Ste C
Cameron, MO 64429
Phone (816) 632-2139

1600 E Evergreen St
Cameron, MO 64429
Phone (816) 632-2101

1602 N 2nd St
Clinton, MO 64735
Phone (660) 885-8171

1600 N 2nd St
Clinton, MO 64735
Phone (660) 885-8171

2800 E Rock Haven Rd
Harrisonville, MO 64701
Phone (816) 380-3474

Interoperability endpoints

  • Direct secure messaging: marija.tonkovic@cassregional.direct-ci.com

Organizations & group practices 7

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 5

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": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1275731010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E EVERGREEN ST",
            "city": "CAMERON",
            "state": "MO",
            "postal_code": "644292400",
            "telephone_number": "816-649-3208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E EVERGREEN ST",
            "city": "CAMERON",
            "state": "MO",
            "postal_code": "644292400",
            "telephone_number": "816-649-3208",
            "fax_number": "816-649-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TONKOVIC-CAPIN",
        "first_name": "MARIJA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "2011006615",
            "primary": false
        },
        {
            "code": "193200000X",
            "taxonomy_group": "",
            "desc": "Multi-Specialty",
            "state": "MO",
            "license": "2011006615",
            "primary": true
        },
        {
            "code": "193200000X",
            "taxonomy_group": "",
            "desc": "Multi-Specialty",
            "state": "KS",
            "license": "94-06648",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275731010",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cameron, MO

Sources for this page

Verify at the official NPI Registry.