Individual provider Active NPI

Amornluck Krasaelap, M.D.

  • Pediatric Gastroenterology Physician
  • Overland Park, KS
National Provider Identifier
1376954461
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
04-43262 Issued in KS
Practice address
5808 W 110TH St
Overland Park, KS 66211-2504
Phone
(913) 696-8000
Fax
(816) 302-9939
NPI assigned
May 12, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 04-43262 KS Primary

Addresses

Primary practice location

5808 W 110TH St
Overland Park, KS 66211-2504

Mailing address

2401 Gillham Rd
Attn: Provider Enrollment Dept
Kansas City, MO 64108-4619
Phone (816) 701-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240614002041 WA Practitioner - Pediatric MedicinePractitioner - Gastroenterology 6204138381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Gastroenterology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4800 Sand Point Way NE
Seattle, WA 98105-3901
Phone (206) 526-2000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Association of CHMC and University Physicians Pediatric Gastroenterology CurrentSince May 13, 2024 Accepting new patients
The Association of Chrmc and University Physicians CurrentSince May 13, 2024 Accepting new patients
Seattle Children'S Hospital Past Accepting new patients

Locations

900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

Interoperability endpoints

  • Direct secure messaging: akrasaelap368030@direct.seattlechildrens.org
  • Direct secure messaging: akrasaelap679711@direct.kuha.org
  • Direct secure messaging: akrasalap413278@direct.hfhs.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1376954461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "address_2": "ATTN: PROVIDER ENROLLMENT DEPT",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-701-5200",
            "fax_number": "816-302-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5808 W 110TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662112504",
            "telephone_number": "913-696-8000",
            "fax_number": "816-302-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASAELAP",
        "first_name": "AMORNLUCK",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-12",
        "last_updated": "2024-04-30",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "KS",
            "license": "04-43262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.