Individual provider Active NPI

Kevin Ong Guevarra, D.O.

  • Family Medicine Physician
  • Olathe, KS
National Provider Identifier
1356744981
Registry record updated Apr 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
05-39454 Issued in KS
Practice address
23450 College Blvd
Olathe, KS 66061-8702
Phone
(913) 764-7788
Fax
(913) 764-6088
NPI assigned
Sep 26, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2020

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 05-39454 KS Primary

Addresses

Primary practice location

23450 College Blvd
Olathe, KS 66061-8702

Mailing address

23450 College Blvd
Olathe, KS 66061-8702
Phone (913) 764-7788

Other identifiers 2

IdentifierTypeStateIssuer
033D00245OtherKSWPS
201148030AMedicaidKS

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161220000824 KS Practitioner - Family Practice 7618258260 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jayhawk Primary Care IncGroup PAC ID 8123928900, 157 clinicians

Practice addresses (Care Compare)

23450 College Blvd
Olathe, KS 66061-8702
Phone (913) 588-1227

7405 Renner Rd
Shawnee, KS 66217-9414
Phone (913) 588-8400

Hospital & facility affiliations

  • Interim Healthcare of Kansas City Home health agency, Overland Park, KS, CCN 177087
  • University of Kansas Hospital Hospital, Kansas City, KS, CCN 170040
  • University of Kansas Health System Olathe Hospital Hospital, Olathe, KS, CCN 170049

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 Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Jayhawk Primary Care Inc Family Medicine CurrentSince Jan 1, 2024 Accepting new patients
Jayhawk Primary Care Inc Family Medicine Current Accepting new patients
Jayhawk Primary Care Inc Family Medicine Past Accepting new patients

Locations

11300 Corporate Ave
Ste 342
Lenexa, KS 66219
Phone (913) 574-0425

23450 College Blvd
Olathe, KS 66061
Phone (913) 355-7788

7405 Renner Rd
Shawnee Msn, KS 66217
Phone (913) 588-2200

Interoperability endpoints

  • Direct secure messaging: kguevarra755601@direct.kuha.org

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 4

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": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1356744981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23450 COLLEGE BLVD",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660618702",
            "telephone_number": "913-764-7788",
            "fax_number": "913-764-6088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23450 COLLEGE BLVD",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660618702",
            "telephone_number": "913-764-7788",
            "fax_number": "913-764-6088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUEVARRA",
        "first_name": "KEVIN",
        "middle_name": "ONG",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-26",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "05-39454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPS",
            "identifier": "033D00245",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201148030A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

Verify at the official NPI Registry.