NPIMap

Individual provider Active NPI

Jeremy Charles Peterson, MD

  • Neurological Surgery Physician
  • Kansas City, KS
National Provider Identifier
1336400456
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
94-07818 Issued in KS
Practice address
University of Kansas Hospital School of
Dept. of Neurosurgery, 3901 Rainbow Blvd., Ms 3021
Kansas City, KS 66160-0001
Phone
(913) 588-6119
Fax
(913) 588-7570
NPI assigned
Jun 5, 2012
Last updated
Sep 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 94-07818 KS Primary

Addresses

Primary practice location

University of Kansas Hospital School of
Dept. of Neurosurgery, 3901 Rainbow Blvd., Ms 3021
Kansas City, KS 66160-0001

Mailing address

2106 Olathe Blvd Ms 3021
Kansas City, KS 66160-0001
Phone (913) 588-6122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210817002061 KS Practitioner - NeurosurgeryPractitioner - Diagnostic Radiology 5496073942 Reassigns benefits to 1 organization
I20220428001595 MO Practitioner - Diagnostic Radiology 5496073942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurosurgeryAlso: Diagnostic Radiology
Education
University of Nebraska College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians

Practice addresses (Care Compare)

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

4000 Cambridge St
Kansas City, KS 66160-8500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.91 of 100Reported as apm
Quality
77.02
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
81.83
Promoting interoperability
99
Improvement activities
40
Cost
74.61

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
94-07818KSMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc Current Accepting new patients
Kansas University Physicians Inc CurrentSince Aug 1, 2021 Accepting new patients
Kansas University Physicians Inc CurrentSince Mar 25, 2022 Accepting new patients
Kansas University Physicians Inc Neurological Surgery CurrentSince Aug 1, 2021 Accepting new patients
University of Kansas Hospital Authority Past Accepting new patients

Locations

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

4000 Cambridge St
Kansas City, KS 66160
Phone (913) 588-3974

11300 Corporate Ave
Lenexa, KS 66219
Phone (913) 574-0600

11300 Corporate Ave
Ste 330
Lenexa, KS 66219
Phone (913) 588-6111

2790 Clay Edwards Dr
Ste 405
North Kansas City, MO 64116
Phone (913) 588-3117

Interoperability endpoints

  • Direct secure messaging: jpeterson153875@direct.kuha.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1336400456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 OLATHE BLVD MS 3021",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661600001",
            "telephone_number": "913-588-6122",
            "fax_number": "913-535-2201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF KANSAS HOSPITAL SCHOOL OF",
            "address_2": "DEPT. OF NEUROSURGERY, 3901 RAINBOW BLVD., MS 3021",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661600001",
            "telephone_number": "913-588-6119",
            "fax_number": "913-588-7570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JEREMY",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-05",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "KS",
            "license": "94-07818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.