Individual provider Active NPI

Molly Bea Menser, D.O.

  • Dermatology Physician
  • Riverside, MO
National Provider Identifier
1306049010
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
2011009214 Issued in MO
Practice address
1805 NW Platte Rd
Suite 120
Riverside, MO 64150-9613
Phone
(816) 472-0400
Fax
(816) 472-0813
NPI assigned
Jun 8, 2007
Last updated
Oct 1, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 2011009214 MO Primary

Addresses

Primary practice location

1805 NW Platte Rd
Suite 120
Riverside, MO 64150-9613

Mailing address

221 W 48TH St
#1507
Kansas City, MO 64112-2680
Phone (913) 956-9909

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110727000074 MO Practitioner - Dermatology 2769650373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epiphany Dermatology of Missouri LLCGroup PAC ID 1153689294, 21 clinicians

Practice addresses (Care Compare)

1805 NW Platte Rd
Suite 120
Riverside, MO 64150-7500
Phone (816) 205-8120

Hospital & facility affiliations

  • NKC Health Hospital, North Kansas City, MO, CCN 260096

Merit-based Incentive Payment System (MIPS)

Final score
88.84 of 100Reported as group
Quality
80.25
Promoting interoperability
100
Improvement activities
40
Cost
82.55

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions202
Removal or shaving of skin growth1-10
Skin biopsy187

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2011009214MOMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Epiphany Dermatology of Missouri, LLC Dermatology CurrentSince Nov 1, 2020 Accepting new patients

Locations

1805 NW Platte Rd
Ste 120
Riverside, MO 64150
Phone (816) 205-8120

805 N 36th St
Ste D
Saint Joseph, MO 64506
Phone (816) 205-8120

2325 Dougherty Ferry Rd
#201
Saint Louis, MO 63122
Phone (314) 993-1714

7300 Ranch Road 2222
Bldg 1
Austin, TX 78730

7300 Ranch Road 2222
Ste 200
Austin, TX 78730

Interoperability endpoints

  • Direct secure messaging: mmenser@epiphanyderm.emadirect.md
  • Direct secure messaging: mmenser@epiphanykc.emadirect.md

Organizations & group practices 1

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": "1181260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1306049010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 W 48TH ST",
            "address_2": "#1507",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641122680",
            "telephone_number": "913-956-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 NW PLATTE RD",
            "address_2": "SUITE 120",
            "city": "RIVERSIDE",
            "state": "MO",
            "postal_code": "641509613",
            "telephone_number": "816-472-0400",
            "fax_number": "816-472-0813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENSER",
        "first_name": "MOLLY",
        "middle_name": "BEA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-08",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "2011009214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, MO

Sources for this page

Verify at the official NPI Registry.