Matthew R Hlavacek, MD, DDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

2005027155 Issued in MO

Practice address

1208 NE Windsor Dr
Lees Summit, MO 64086-5594

Phone

(816) 524-4334

Fax

(816) 524-4399

NPI assigned

Jan 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• University Health Physicians

  • Internal Medicine Physician
  • Kansas City, MO
  • NPI 1669456257

  Oral & Maxillofacial Surgery

  NPD (past)

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1285613240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 NE WINDSOR DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865594",
            "telephone_number": "816-524-4334",
            "fax_number": "816-524-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 NE WINDSOR DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865594",
            "telephone_number": "816-524-4334",
            "fax_number": "816-524-4399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HLAVACEK",
        "first_name": "MATTHEW",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "MD, DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "016083",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "2005027155",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "016083",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MO",
            "license": "2005027155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204017107",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404017105",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keesha Nicole Hinkle, PLPC
• Kelsi Hinrichs
• Emily K Hirsch, DPT
• Karanita Berniece Hite, LCSW
• Stacey Leigh Hittle, MS, CCC-SLP
• HML Chiropractic & Functional Care LLC
• Mackenzie Hoback, RBT
• Chase Hobbs, DO
• Maeve Hodes
• Geri V Hoerman, LCSW, ACSW

• Oral & Maxillofacial Surgery (D.M.D.) in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.