Alec Neitzel, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2026011607 Issued in MO

Practice address

601 NW Obrien Rd
Lees Summit, MO 64063-1806

Phone

(816) 287-1528

Fax

(343) 503-0640

NPI assigned

Oct 2, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, MO2 enrollments

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 2

Specialty

Physician Assistant

Education

Southern Illinois University School of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cornerstone Dermatology and Surgery Group PCGroup PAC ID 3870856669, 8 clinicians

Vitalskin Medical Group Il PLLCGroup PAC ID 5991116261, 56 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Cornerstone Dermatology & Surgery Group, PC

  • Procedural Dermatology Physician
  • Lee's Summit, MO
  • NPI 1114427739
  Medicare reassignment Care Compare group NPD
• Vitalskin Medical Group Il PLLC

  • Dermatology Physician
  • Mattoon, IL
  • NPI 1063030252

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Decatur Memorial Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1164477725
  NPD (past)

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

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1366260820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 NW OBRIEN RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640631806",
            "telephone_number": "816-287-1528",
            "fax_number": "343-503-0640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 NW OBRIEN RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640631806",
            "telephone_number": "816-287-1528",
            "fax_number": "343-503-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEITZEL",
        "first_name": "ALEC",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-02",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2026011607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirk Allen Neely, RPH
• Madison Neely, DC
• Owen H Neff Jr., RPH., MBA
• Grace Neiderhiser, PLPC
• Lorenzo Kidd Neilsen, D.D.S.
• Alex Nelson, D.C.
• Caroline Nelson, PT, DPT
• Darryl K Nelson, MD
• Jennifer Nelson
• Lindsay Nelson, RD, LD

• Physician Assistant in Lee's Summit, MO
• Providers in Lee's Summit, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; 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.