Associated Plastic Surgeons PA

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

ASSOCIATED PLASTIC SURGEONS PA

Practice address

11501 Granada St
Leawood, KS 66211-1454

Phone

(913) 451-3722

Fax

(913) 451-5000

NPI assigned

Jul 18, 2005

Organization subpart

No

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

Authorized official

Name

Elizabeth Lisa G Jackson

Title

Credentialing Coordinator

Phone

(913) 451-3722

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Associated Plastic Surgeons, PA Doing business as

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joseph V. Cannova Jr., M.D.

  • Plastic and Reconstructive Surgery Physician
  • Leawood, KS
  • NPI 1225037732

  KS

  Medicare reassignment Care Compare group NPD
• Elizabeth Anne Killion, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Leawood, KS
  • NPI 1043570823

  KS

  Medicare reassignment Care Compare group NPD
• Mark McClung, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Leawood, KS
  • NPI 1750380267

  KS

  Medicare reassignment Care Compare group NPD
• Jon Rast, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Leawood, KS
  • NPI 1659370922

  KS

  Medicare reassignment Care Compare group NPD
• Nahid Shahrooz, MD

  • Dermatology Physician
  • Leawood, KS
  • NPI 1649272097

  KS

  Medicare reassignment Care Compare group NPD
• Jacob Daniel Smith, MD

  • Plastic Surgery Physician
  • Leawood, KS
  • NPI 1306378195

  KS

  Medicare reassignment Care Compare group NPD
• Sheryl L Young, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Leawood, KS
  • NPI 1962401232

  KS

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739318400000",
    "number": "1366441966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11501 GRANADA ST",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111454",
            "telephone_number": "913-451-3722",
            "fax_number": "913-451-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11501 GRANADA ST",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111454",
            "telephone_number": "913-451-3722",
            "fax_number": "913-451-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2861 NE Independence Ave Ste 205",
            "address_purpose": "LOCATION",
            "city": "Lees Summit",
            "state": "MO",
            "postal_code": "640642379",
            "country_code": "US",
            "telephone_number": "913-451-3722 x300",
            "fax_number": "913-451-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ASSOCIATED PLASTIC SURGEONS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-18",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ELIZABETH LISA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "913-451-3722"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CP7309",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Associated Plastic Surgeons, PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Leawood, KS
• Specialist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.