Individual provider Active NPI

Pascal Nyachowe, M.D.

  • Trauma Surgery Physician
  • Kansas City, MO
National Provider Identifier
1285684167
Registry record updated Nov 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
2005039880 Issued in MO
Practice address
4320 Wornall Rd Ste 5320
Kansas City, MO 64111-5941
Phone
(816) 932-2836
Fax
(816) 932-9868
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X 2005039880 MO Primary

Addresses

Primary practice location

4320 Wornall Rd Ste 5320
Kansas City, MO 64111-5941

Mailing address

901 E 104TH St
Mailstop 400
Kansas City, MO 64131
Phone (816) 502-8755

Other identifiers 1

IdentifierTypeStateIssuer
200136406MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060405000581 MO Practitioner - General Surgery 8325069149 Reassigns benefits to 2 organizations
I20151217000372 IL Practitioner - General Surgery 8325069149

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Howard University College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Missouri Delta Medical CenterGroup PAC ID 1355252891, 134 clinicians

Practice addresses (Care Compare)

1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 471-1600

Hospital & facility affiliations

  • Missouri Delta Medical Center Hospital, Sikeston, MO, CCN 260113

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2005039880MOMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Specialty Associates of Missouri LLC CurrentSince Oct 31, 2022 Accepting new patients
Missouri Delta Medical Center CurrentSince Feb 4, 2024 Accepting new patients
Missouri Delta Medical Center CurrentSince Feb 4, 2024 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Mercy Clinic Trauma and General Surgery, LLC Trauma Surgery PastSince Sep 1, 2010 Accepting new patients

Locations

2316 E Meyer Blvd
Kansas City, MO 64132
Phone (816) 276-4360

1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600

Organizations & group practices 5

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510704000000",
    "number": "1285684167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E 104TH ST",
            "address_2": "MAILSTOP 400",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64131",
            "telephone_number": "816-502-8755",
            "fax_number": "816-932-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 WORNALL RD STE 5320",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641115941",
            "telephone_number": "816-932-2836",
            "fax_number": "816-932-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYACHOWE",
        "first_name": "PASCAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2017-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "MO",
            "license": "2005039880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200136406",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.