Active NPI
Roland Sabates, MD
- Ophthalmology Physician
- Kansas City, MO
National Provider Identifier
1417993676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- MO-R3C19
- Practice address
- 520 E 63Rd St
Kansas City, MO 64110-3330 - Phone
- (816) 333-8600
- Fax
- (816) 444-3304
- NPI assigned
- Jun 22, 2006
- Last updated
- May 18, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | MO-R3C19 | MO | Primary |
Addresses
Primary practice location
520 E 63Rd St
Kansas City, MO 64110-3330
Mailing address
520 E 63Rd St
Kansas City, MO 64110-3330
Phone (816) 333-8600
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100133460A | Medicaid | KS | |
| 09720149 | Other | MO | BCBS-CC LOCATION |
| 09720119 | Other | MO | BCBS |
| 201750437 | Medicaid | MO | |
| 09720109 | Other | MO | BCBS- SL LOCATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MO-R3C19 | MO | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652832000000",
"number": "1417993676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 E 63RD ST",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641103330",
"telephone_number": "816-333-8600",
"fax_number": "816-444-3304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 E 63RD ST",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641103330",
"telephone_number": "816-333-8600",
"fax_number": "816-444-3304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SABATES",
"first_name": "ROLAND",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-22",
"last_updated": "2022-05-18",
"certification_date": "2022-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MO",
"license": "MO-R3C19",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100133460A",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS-CC LOCATION",
"identifier": "09720149",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "09720119",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201750437",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS- SL LOCATION",
"identifier": "09720109",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.