Individual provider Active NPI

Kelly Michael James

  • Surgery Physician
  • Independence, MO
National Provider Identifier
1366428302
Registry record updated May 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD104164 Issued in MO
Practice address
19101 E Valley View Pkwy
Suite B
Independence, MO 64055-6904
Phone
(816) 254-9292
Fax
(816) 795-8996
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD104164 MO Primary

Addresses

Primary practice location

19101 E Valley View Pkwy
Suite B
Independence, MO 64055-6904

Mailing address

19101 E Valley View Pkwy
Suite B
Independence, MO 64055-6904
Phone (816) 254-9292

Other identifiers 2

IdentifierTypeStateIssuer
19543010OtherMOBLUE CROSS-BLUE SHIELD
206857203MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20120114000046 MO Practitioner - General Surgery 0143227843 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Albert Einstein College of Medicine of Yeshiva University, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Surgical Care of Independence IncGroup PAC ID 4385735554, 2 clinicians

Practice addresses (Care Compare)

19101 E Valley View Pkwy
Suite B
Independence, MO 64055-6907
Phone (816) 714-6716

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.19 of 100Reported as group
Quality
50.01
Improvement activities
40
Cost
79.17

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue287
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD104164MOMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Orthopedics and Sports Medicine CurrentSince Oct 1, 2024 Accepting new patients
Advanced Orthopedics and Sports Medicine CurrentSince Oct 1, 2024 Accepting new patients

Locations

19101 E Valley View Pkwy
Ste B
Independence, MO 64055
Phone (816) 254-9292

2861 NE Independence Ave
Ste 201
Lees Summit, MO 64064
Phone (660) 281-8118

Interoperability endpoints

  • Direct secure messaging: kelly.james.1@24152.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304294400000",
    "number": "1366428302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19101 E VALLEY VIEW PKWY",
            "address_2": "SUITE B",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556904",
            "telephone_number": "816-254-9292",
            "fax_number": "816-795-8996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19101 E VALLEY VIEW PKWY",
            "address_2": "SUITE B",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556904",
            "telephone_number": "816-254-9292",
            "fax_number": "816-795-8996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES",
        "first_name": "KELLY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2011-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "MD104164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-BLUE SHIELD",
            "identifier": "19543010",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206857203",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.