Individual provider Active NPI

Moya C Peterson, A.R.N.P.

  • Nurse Practitioner
  • Kansas City, KS
National Provider Identifier
1316043664
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
44161 Issued in KS
Practice address
3901 Rainbow Blvd
Ms 4017
Kansas City, KS 66160-8500
Phone
(913) 588-1944
Fax
(913) 588-2496
NPI assigned
Sep 15, 2006
Last updated
Jul 16, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 44161 KS Primary

Addresses

Primary practice location

3901 Rainbow Blvd
Ms 4017
Kansas City, KS 66160-8500

Mailing address

PO Box 411851
Kansas City, MO 64141-1851
Phone (913) 588-1944

Other identifiers 5

IdentifierTypeStateIssuer
100248630BMedicaidKS
500008548OtherRAILROAD MEDICARE
26926013OtherMOBCBS KANSAS CITY
412690OtherKSFIRSTGUARD
424843506MedicaidMO

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
I20100817000046 KS Practitioner - Nurse Practitioner 0042344889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians

Practice addresses (Care Compare)

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

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

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

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
44161KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc Current Accepting new patients
Kansas University Physicians Inc CurrentSince Jul 1, 1999 Accepting new patients
Kansas University Physicians Inc CurrentSince Jul 1, 1999 Accepting new patients

Locations

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

3901 Rainbow Blvd
#4010
Kansas City, KS 66160
Phone (913) 588-1902

3901 Rainbow Blvd
#4017
Kansas City, KS 66160
Phone (913) 588-1944

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1316043664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411851",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641411851",
            "telephone_number": "913-588-1944",
            "fax_number": "913-588-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "address_2": "MS 4017",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608500",
            "telephone_number": "913-588-1944",
            "fax_number": "913-588-2496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "MOYA",
        "middle_name": "C",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "44161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100248630B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "500008548",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KANSAS CITY",
            "identifier": "26926013",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTGUARD",
            "identifier": "412690",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "424843506",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.