Jennifer L Distasio, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

2010019752 Issued in MO

Practice address

2790 Clay Edwards Dr Ste 1200
North Kansas City, MO 64116-3253

Phone

(816) 468-7800

Fax

(816) 468-8531

NPI assigned

Jun 10, 2010

Last updated

Oct 19, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Obstetrics/Gynecology

Education

Saint Louis University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Meritas Health CorporationGroup PAC ID 6305748153, 492 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• NKC Health Hospital, North Kansas City, MO, CCN 260096

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Meritas Health Corporation

  dba NKC Health

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1801875091
  Medicare reassignment Care Compare group NPD
• Meritas Health Corporation

  dba NKC Health

  • Obstetrics & Gynecology Physician
  • North Kansas City, MO
  • NPI 1609112937
  NPD
• Meritas Health Corporation

  • Neurology Physician
  • Kansas City, MO
  • NPI 1669323291
  NPD
• Meritas Health Corporation

  dba NKC Health

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1184917288
  NPD (past)
• Meritas Health Corporation

  dba NKC Health

  • Family Medicine Physician
  • Kansas City, MO
  • NPI 1619606159
  NPD (past)
• North Kansas City Hospital

  dba NKC Health

  • General Acute Care Hospital
  • North Kansas City, MO
  • NPI 1629062799
  NPD (past)

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

• North Kansas City Hospital

  dba Skilled Nursing Unit

  • Skilled Nursing Facility
  • North Kansas City, MO
  • NPI 1437103215

  Hospital

  Care Compare affiliation
• North Kansas City Hospital

  dba NKC Health

  • General Acute Care Hospital
  • North Kansas City, MO
  • NPI 1629062799
  Care Compare affiliation

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

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508371200000",
    "number": "1396065447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 CLAY EDWARDS DR STE 1200",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163253",
            "telephone_number": "816-468-7800",
            "fax_number": "816-468-8531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 CLAY EDWARDS DR STE 1200",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163253",
            "telephone_number": "816-468-7800",
            "fax_number": "816-468-8531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISTASIO",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-10",
        "last_updated": "2017-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2010019752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396065447",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelley Hagan Delong, M.D.
• Allison Denoble
• Charles A Devillier, PHARMD
• Nadiya Dibenedetto
• Meredith Anne Dipasquale, APRN, BC
• James Bohannon Dixon, DDS
• Rylee P DO, MD
• Katie Jo Donegan, CRNA
• Laura Donnell, CRNA
• David Alexander Donnelly, DO

• Obstetrics & Gynecology Physician in North Kansas City, MO
• Providers in North Kansas City, MO by specialty
• Obstetrics & Gynecology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; 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.