Nicole Petrillo, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

04-50947 Issued in KS

Practice address

7440 W Frontage Rd
Shawnee Mission, KS 66203-4670

Phone

(913) 236-6455

NPI assigned

Apr 7, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Physician Services LLCGroup PAC ID 1658500962, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nkagan826934@direct.sw.org
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Mid America Physician Services

  • Obstetrics & Gynecology Physician
  • Shawnee Mission, KS
  • NPI 1952734741

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Johnson County OB-GYN Chartered

  • Obstetrics & Gynecology Physician
  • Merriam, KS
  • NPI 1629178611

  Single Specialty

  NPD (past)
• Shawnee Mission Medical Center Inc

  • General Acute Care Hospital
  • Merriam, KS
  • NPI 1023171634
  NPD (past)
• Womens Care

  • Obstetrics & Gynecology Physician
  • Shawnee Mission, KS
  • NPI 1669478517

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1336728278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10906 W 169TH TER",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662217954",
            "telephone_number": "913-206-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7440 W FRONTAGE RD",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662034670",
            "telephone_number": "913-236-6455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 Gaston Ave",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752462017",
            "country_code": "US",
            "telephone_number": "236-121-4820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRILLO",
        "first_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "KS",
            "license": "04-50947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph A Petersen Jr.
• Joseph A Petersen Sr.
• Leah Petersen, RPT
• Maria Petersen, ARNP
• John E Peterson, MD
• Alanna Marie Pfister, RN, APRN, AGACNP-BC
• John L Pham, MD
• Angela L Piquard, M.D.
• Podiatry Associates, PA
• Jennifer Michelle Powell, P.T., M.S.

• Obstetrics & Gynecology Physician in Shawnee Mission, KS
• Providers in Shawnee Mission, KS by specialty
• Obstetrics & Gynecology Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.