NPIMap

Individual provider Active NPI

Constance M Irick, M.D.

  • Family Medicine Physician
  • Olathe, KS
National Provider Identifier
1346235272
Registry record updated Feb 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
04-22030 Issued in KS
Practice address
15270 W 119TH St
Olathe, KS 66062-5604
Phone
(913) 829-8833
Fax
(913) 768-4827
NPI assigned
Sep 16, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 04-22030 KS Primary

Addresses

Primary practice location

15270 W 119TH St
Olathe, KS 66062-5604

Mailing address

15270 W 119TH St
Olathe, KS 66062-5604
Phone (913) 829-8833

Other identifiers 1

IdentifierTypeStateIssuer
13429045OtherBCBSKC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040813000853 KS Practitioner - Family Practice 1052384518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11020 King St
Suite 220
Overland Park, KS 66210-1201
Phone (913) 829-8833

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.56 of 100Reported as individual
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
71.86

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-22030KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Irick Family Medicine, PA Family Medicine CurrentSince Aug 13, 2004 Accepting new patients
State Line Medical Group LLC Past Accepting new patients
Menorah Family Physicians LLC Family Medicine Past Accepting new patients
Priority Care, LLC Past Accepting new patients

Locations

15270 W 119th St
Olathe, KS 66062
Phone (913) 541-1131

11020 King St
Ste 220
Overland Park, KS 66210
Phone (913) 345-2622

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CHIBBA

Organizations & group practices 4

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 7

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": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265932800000",
    "number": "1346235272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15270 W 119TH ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660625604",
            "telephone_number": "913-829-8833",
            "fax_number": "913-768-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15270 W 119TH ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660625604",
            "telephone_number": "913-829-8833",
            "fax_number": "913-768-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRICK",
        "first_name": "CONSTANCE",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-16",
        "last_updated": "2010-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-22030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSKC",
            "identifier": "13429045",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

Verify at the official NPI Registry.