Individual provider Active NPI

Misty Stambach, PA-C

  • Medical Physician Assistant
  • Kansas City, MO
National Provider Identifier
1396085395
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2013005694 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
Feb 27, 2013
Last updated
Feb 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2013005694 MO Primary

Addresses

Primary practice location

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

Mailing address

4321 Washington St Ste 3000
Kansas City, MO 64111-5928
Phone (816) 932-3100

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130429000119 MO Practitioner - Physician Assistant 7113163627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

4321 Washington
Kansas City, MO 64111-5928

601 S 169 Hwy
Smithville, MO 64089-9317
Phone (816) 532-3700

601 S US Hwy 169
Smithville, MO 64089-9317
Phone (816) 532-3999

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2013005694MOMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke's Physician Group Inc CurrentSince Jan 9, 2023 Accepting new patients
Saint Lukes Physician Group Inc CurrentSince Jan 9, 2023 Accepting new patients
Manning Family Care, LLC Past Accepting new patients

Locations

4321 Washington St
Ste 3000
Kansas City, MO 64111
Phone (816) 932-3100

901 E 104th St
#400N
Kansas City, MO 64131
Phone (816) 502-8756

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Interoperability endpoints

  • Direct secure messaging: mstambach377694@direct.saint-lukes.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1396085395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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": [],
    "basic": {
        "last_name": "STAMBACH",
        "first_name": "MISTY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-27",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MO",
            "license": "2013005694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.