Benjamin Petelin, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2016028966 Issued in MO

Practice address

4321 Washington St Ste 3000
Kansas City, MO 64111-5928

Phone

(816) 932-3100

Fax

(816) 932-6871

NPI assigned

Jun 24, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KS, MO2 enrollments

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 2

Specialty

Internal Medicine

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jayhawk Primary Care IncGroup PAC ID 8123928900, 157 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aquinas Home Health Home health agency, Shawnee, KS, CCN 178008
• University of Kansas Hospital Hospital, Kansas City, KS, CCN 170040
• St Lukes Hospital of Kansas City Hospital, Kansas City, MO, CCN 260138
• University of Kansas Health System Olathe Hospital Hospital, Olathe, KS, CCN 170049
• Saint Luke'S South Hospital Hospital, Overland Park, KS, CCN 170185

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bpetelin102005@direct.saint-lukes.org
• Direct secure messaging: benjamin.petelin@hca2.eclinicaldirectplus.com
• Direct secure messaging: bpetelin12777@direct.kuha.org

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.

• Jayhawk Primary Care Inc

  • Family Medicine Physician
  • Shawnee, KS
  • NPI 1528025053

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Saint Luke'S Physician Group Inc

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1093263717

  Internal Medicine

  Medicare reassignment NPD
• Jayhawk Primary Care Inc

  • Internal Medicine Physician
  • Kansas City, KS
  • NPI 1376324152
  NPD
• Jayhawk Primary Care Inc

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1982665436
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Lukes Hospital of Kansas City

  • General Acute Care Hospital
  • Kansas City, MO
  • NPI 1063494177
  Care Compare affiliation
• St Lukes Hospital of Kansas City

  • General Acute Care Hospital
  • Kansas City, MO
  • NPI 1932642972
  Care Compare affiliation
• St. Luke'S Hospital of Kansas City

  • General Acute Care Hospital
  • Liberty, MO
  • NPI 1275926198
  Care Compare affiliation
• Olathe Medical Center Inc

  • General Acute Care Hospital
  • Olathe, KS
  • NPI 1144266115
  Care Compare affiliation
• Saint Lukes South Hospital, Inc.

  • General Acute Care Hospital
  • Overland Park, KS
  • NPI 1154303337
  Care Compare affiliation
• Spectrum Private Care Services, LLC

  • Home Health Agency
  • Shawnee, KS
  • NPI 1205832987
  Care Compare affiliation
• University of Kansas Hospital Authority

  • General Acute Care Hospital
  • Kansas City, KS
  • NPI 1629369681
  Care Compare affiliation
• University of Kansas Hospital Authority

  • General Acute Care Hospital
  • Kansas City, KS
  • NPI 1649259656
  Care Compare affiliation

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1386955334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E. 104TH ST",
            "address_2": "MAILSTOP 400N",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "64131",
            "telephone_number": "816-502-7104",
            "fax_number": "816-932-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 WASHINGTON ST STE 3000",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641115928",
            "telephone_number": "816-932-3100",
            "fax_number": "816-932-6871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10601 Quivira Rd",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Overland Park",
            "state": "KS",
            "postal_code": "662152310",
            "country_code": "US",
            "telephone_number": "913-541-3340",
            "fax_number": "913-492-7857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETELIN",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-24",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "0536409",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2016028966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Personal & Family Development Services PTR
• Personal and Family Development Associates, Inc.
• Personalized Acute Medical Transportation LLC
• Mark E Persson, DDS
• Micah Pescetto, DO
• Nicholas J. Petelin, CRNA
• Peter E. Shapiro, M.D., L.L.C.
• Allison Peter, AUD
• Christie Peterfish, DPT
• Courtney Peters, LMSW

• Internal Medicine Physician in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; 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.