Nicole Fremarek, DO, MBA
Individual provider Active NPI Sports Medicine (Family Medicine) Physician · Lees Summit, MO
NPI 1417410705 · NPPES record last updated Nov 27, 2024
Key facts
- NPI
- 1417410705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Sports Medicine (Family Medicine) Physician 207QS0010X
- License
- 2024037892 (MO)
- Practice address
- 2861 NE Independence Ave Ste 201
Lees Summit, MO 64064-2379 - Phone
- (816) 525-2840
- Fax
- (816) 525-2841
- NPI assigned
- Apr 12, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Kansas City University of Med & Biosciences, College of Osteo Med, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Advanced Orthopedics and Sports Medicine
Practice addresses (Care Compare)
11340 Nall Ave
Suite 200
Overland Park, KS 66211-1234
Phone (816) 525-2840
2861 NE Independence Ave
Suite 201
Lees Summit, MO 64064-2379
Phone (816) 525-2840
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in VA, KS, MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230717002988 | VA | Practitioner - Osteopathic Manipulative Medicine | 1557696622 | Reassigns benefits to 1 organization |
| I20241204001997 | KS | Practitioner - Family Practice |
1557696622 | Reassigns benefits to 1 organization |
| I20241204002155 | MO | Practitioner - Family Practice |
1557696622 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Master of Business Administration
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Orthopedics and Sports Medicine | Current |
Accepting new patients | |
| Academic Primary Care Associates | Neuromusculoskeletal Medicine & Omm | Current |
Accepting new patients |
| Academic Primary Care Associates | Current |
Accepting new patients | |
| Advanced Orthopedics and Sports Medicine | Current |
Accepting new patients |
Locations
11340 Nall Ave
Ste 200
Overland Park, KS 66211
Phone (913) 354-5020
505 S Hospital Dr
Paola, KS 66071
Phone (913) 232-9846
2861 NE Independence Ave
Ste 201
Lees Summit, MO 64064
Phone (660) 281-8118
1691 Innovation Dr
Ste 2100
Blacksburg, VA 24060
Phone (540) 232-8405
Interoperability endpoints
- nfremarek676109@direct.trinity-health.org
- https://api.platform.athenahealth.com/26460/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuromusculoskeletal Medicine & OMM Physician | 204D00000X | 2024037892 | MO | |
| Sports Medicine (Family Medicine) Physician | 207QS0010X | 2024037892 | MO | Yes |
Addresses
Primary practice location
2861 NE Independence Ave Ste 201
Lees Summit, MO 64064-2379
Mailing address
1750 Independence Ave
Kansas City, MO 64106-1453
Phone (816) 654-7000
Other practice location 1
11340 Nall Ave Ste 200
Overland Park, KS 66211-1234
Phone (816) 525-2840
Other providers in Lees Summit, MO
- Eileen Fratzke
- Heidi Frazier
- Kate Marie Frazier
- Monica Faye Frazier
- Brianna Frederick
- Marguerite Devonne French
- Pooja Thakur French
- Rachael Michelle Dawn French
- Larry Frederick Frevert
- Warren Frevert
All providers in Lees Summit, MO · Sports Medicine (Family Medicine) Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.