Midtown Family Medicine PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

36683 Issued in MO

Legal business name

MIDTOWN FAMILY MEDICINE PC

Practice address

3406 Broadway Blvd Ste B
Kansas City, MO 64111-2767

Phone

(816) 756-5839

Fax

(816) 756-5874

NPI assigned

Mar 13, 2009

Organization subpart

No

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

Authorized official

Name

Susan Diebold

Title

Office Manager

Phone

(816) 756-5839

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 11

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

• Tamayo S Jacobs, MD

  • Internal Medicine Physician
  • Kansas City, MO
  • NPI 1447255005

  MO

  Medicare reassignment Care Compare group NPD
• Brett A Nolte, APRN-C

  • Adult Health Nurse Practitioner
  • Kansas City, MO
  • NPI 1982497350

  MO

  Medicare reassignment Care Compare group NPD
• Haseeb Abdul Ahmed, DO

  • Internal Medicine Physician
  • Overland Park, KS
  • NPI 1972701571

  MO, Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Sheza Faruqi, PA-C

  • Physician Assistant
  • Kansas City, MO
  • NPI 1013725803

  MO

  Medicare reassignment Care Compare group
• Margaret M Harrigan, PA-C

  • Physician Assistant
  • Kansas City, MO
  • NPI 1356235014

  MO

  Medicare reassignment Care Compare group
• Margaret Mary Schmidtlein, APRN

  • Family Nurse Practitioner
  • Kansas City, MO
  • NPI 1962778407

  MO

  Medicare reassignment Care Compare group
• Madeline Moding Bartsch, FNP-C

  • Family Nurse Practitioner
  • Overland Park, KS
  • NPI 1265260665

  MO

  Medicare reassignment NPD
• Marian Louise Phelps, FNP-BC

  • Family Nurse Practitioner
  • Overland Park, KS
  • NPI 1114684313

  MO

  Medicare reassignment NPD
• Kevin Yok Hai Wu, MD

  • Internal Medicine Physician
  • Kansas City, KS
  • NPI 1891130936

  MO

  Medicare reassignment NPD
• Lisa Wiley, APRN-C

  • Nephrology Physician
  • Kansas City, MO
  • NPI 1346005337
  NPD
• Samiran D Patel, M.D.

  • Pulmonary Disease Physician
  • Overland Park, KS
  • NPI 1295825685
  NPD

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618358400000",
    "number": "1376784835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3406 BROADWAY BLVD STE B",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641112767",
            "telephone_number": "816-756-5839",
            "fax_number": "816-756-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3406 BROADWAY BLVD STE B",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641112767",
            "telephone_number": "816-756-5839",
            "fax_number": "816-756-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDTOWN FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-13",
        "last_updated": "2021-04-14",
        "certification_date": "2020-12-14",
        "status": "A",
        "authorized_official_last_name": "DIEBOLD",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "816-756-5839"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "36683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Jo Middleton, M.D.
• Michelle Renee Middleton, AU.D.
• Roseanne Marie Middleton, PH.D.
• Midland Health Care, LLC
• Midtown Dental LLC
• Midtown Health Center, LLC
• Midtown Muscle and Joint LLC
• Midtown Orthodontics, LLC
• Midtown Pediatric Dentistry
• Midtown Psychological Services, Inc.

• All providers in Kansas City, MO
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.