Individual provider Active NPI

Collin Kitzerow, M.D.

  • Anesthesiology Physician
  • Kansas City, MO
National Provider Identifier
1356798904
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2020012205 Issued in MO
Practice address
4401 Wornall Rd
Kansas City, MO 64111-3220
Phone
(816) 932-3679
Fax
(816) 932-9089
NPI assigned
May 24, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 94-08870 KS
Anesthesiology Physician 207L00000X 2020012205 MO Primary

Addresses

Primary practice location

4401 Wornall Rd
Kansas City, MO 64111-3220

Mailing address

901 E 104TH St
Kansas City, MO 64131-4517
Phone (816) 932-3679

Other practice location 1

1010 N Kansas St
Wichita, KS 67214-3124
Phone (316) 268-6147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200708001195 MO Practitioner - Anesthesiology 7517250483 Reassigns benefits to 1 organization
I20220308000110 KS Practitioner - Anesthesiology 7517250483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Kansas School of Med (KC/Wich/Sal), 2016
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)

12300 Metcalf Ave
Overland Park, KS 66213-1324
Phone (913) 317-7000

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

Hospital & facility affiliations

  • St Lukes Hospital of Kansas City Hospital, Kansas City, MO, CCN 260138

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
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke'S Physician Group Inc CurrentSince Jul 6, 2020 Accepting new patients

Locations

711 Marshall St
Leavenworth, KS 66048
Phone (913) 684-1100

12330 Metcalf Ave
Ste 500A
Overland Park, KS 66213
Phone (913) 323-9000

12300 Metcalf Ave
Shawnee Mission, KS 66213
Phone (913) 317-7000

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

901 E 104th St
Kansas City, MO 64131
Phone (816) 502-7117

901 E 104th St
#400S
Kansas City, MO 64131
Phone (816) 502-7117

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

Interoperability endpoints

  • Direct secure messaging: ckitzerow386055@direct.saint-lukes.org

Organizations & group practices 1

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": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1356798904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E 104TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641314517",
            "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": [
        {
            "address_1": "1010 N Kansas St",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672143124",
            "country_code": "US",
            "telephone_number": "316-268-6147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KITZEROW",
        "first_name": "COLLIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-24",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KS",
            "license": "94-08870",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2020012205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.