Individual provider Active NPI

Juan Pablo Portocarrero Caceres, M.D

  • Nephrology Physician
  • Kansas City, KS
National Provider Identifier
1437680972
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
125070123 Issued in IL
Practice address
3901 Rainbow Blvd # Ms 3002
Kansas City, KS 66160-2908
Phone
(913) 588-6048
NPI assigned
Mar 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125070123 IL
Nephrology Physician 207RN0300X 125070123 IL Primary

Addresses

Primary practice location

3901 Rainbow Blvd # Ms 3002
Kansas City, KS 66160-2908

Mailing address

3901 Rainbow Blvd # Ms 3002
Kansas City, KS 66160-8500
Phone (913) 588-6048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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

Enrollment IDStateProvider typePAC IDDetails
I20230802002777 KS Practitioner - Nephrology 0547531188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians

Practice addresses (Care Compare)

4000 Cambridge St
Kansas City, KS 66160-0001
Phone (913) 588-1227

Hospital & facility affiliations

  • University of Kansas Hospital Hospital, Kansas City, KS, CCN 170040
  • University of Kansas Health System Olathe Hospital Hospital, Olathe, KS, CCN 170049

Merit-based Incentive Payment System (MIPS)

Final score
92.91 of 100Reported as apm
Quality
77.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc Internal Medicine Current Accepting new patients
Kansas University Physicians Inc Internal Medicine CurrentSince Jul 17, 2023 Accepting new patients
Kansas University Physicians Inc CurrentSince Jul 17, 2023 Accepting new patients

Locations

4000 Cambridge St
Kansas City, KS 66160
Phone (913) 588-0000

3901 Rainbow Blvd
#3002
Kansas City, KS 66160
Phone (913) 588-6048

3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005

11300 Corporate Ave
Ste 342
Lenexa, KS 66219
Phone (913) 574-0425

Interoperability endpoints

  • Direct secure messaging: jportocarrerocaceres717720@direct.kuha.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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1490486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1437680972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD # MS 3002",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608500",
            "telephone_number": "913-588-6048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD # MS 3002",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661602908",
            "telephone_number": "913-588-6048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTOCARRERO CACERES",
        "first_name": "JUAN",
        "middle_name": "PABLO",
        "name_prefix": "Mr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-26",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125070123",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "125070123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.