Individual provider Active NPI

Melissa Marie Roberts, PA-C

  • Physician Assistant
  • Kansas City, MO
National Provider Identifier
1336623800
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
363A00000X Issued in MO
Practice address
4401 Wornall Rd
Kansas City, MO 64111-3220
Phone
(816) 932-3679
Fax
(816) 932-9089
NPI assigned
Sep 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 363A00000X MO Primary

Addresses

Primary practice location

4401 Wornall Rd
Kansas City, MO 64111-3220

Mailing address

4401 Wornall Rd
Kansas City, MO 64111-3220
Phone (816) 932-3679

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230731000828 MO Practitioner - Physician Assistant 8628312840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

4401 Wornall Rd
Kansas City, MO 64111-3220
Phone (816) 932-3100

601 S 169 Hwy
Smithville, MO 64089-9317
Phone (816) 532-3700

601 S US Hwy 169
Smithville, MO 64089-9317
Phone (816) 532-3999

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.56 of 100Reported as group
Quality
76.07
Promoting interoperability
100
Improvement activities
40
Cost
65.79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
363A00000XMOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Lukes Physician Group Inc Physician Assistant CurrentSince Jul 31, 2023 Accepting new patients
Saint Luke's Physician Group Inc CurrentSince Jul 31, 2023 Accepting new patients

Locations

4401 Wornall Rd
Kansas City, MO 64111
Phone (816) 932-2107

5844 NW Barry Rd
Ste 110
Kansas City, MO 64154
Phone (816) 880-6100

901 E 104th St
Ste 400
Kansas City, MO 64131
Phone (816) 502-8752

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Organizations & group practices 2

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 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": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1336623800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 WORNALL RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113220",
            "telephone_number": "816-932-3679",
            "fax_number": "816-932-9089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 WORNALL RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113220",
            "telephone_number": "816-932-3679",
            "fax_number": "816-932-9089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-20",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "363A00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.