Individual provider Active NPI

James P Demetriou, MD

  • Family Medicine Physician
  • Independence, MO
National Provider Identifier
1447298583
Registry record updated Feb 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2025049483 Issued in MO
Practice address
19401 E 39TH St S
Independence, MO 64057-2308
Phone
(816) 490-4277
Fax
(855) 446-7160
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2025049483 MO Primary

Addresses

Primary practice location

19401 E 39TH St S
Independence, MO 64057-2308

Mailing address

6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168

Other identifiers 1

IdentifierTypeStateIssuer
120259600MedicaidWY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address james.demetriou.1@29601.direct.athenahealth.com

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251211003817 MO Practitioner - Family Practice 3779550280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Saint Louis University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

19401 E 39TH St S
Independence, MO 64057-2308
Phone (816) 490-4277

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2025049483MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centerwell Senior Primary Care (Mo) PC Family Medicine CurrentSince Dec 15, 2025 Accepting new patients
Sublette County Hospital District Family Medicine Current Accepting new patients
Centerwell Senior Primary Care (Mo) PC Family Medicine CurrentSince Dec 15, 2025 Accepting new patients

Locations

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

1513 Main St
Grandview, MO 64030
Phone (816) 731-1890

19401 E 39th St S
Independence, MO 64057
Phone (816) 490-4277

Interoperability endpoints

  • Direct secure messaging: james.demetriou.1@29601.direct.athenahealth.com

Organizations & group practices 4

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 1

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1447298583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19401 E 39TH ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572308",
            "telephone_number": "816-490-4277",
            "fax_number": "855-446-7160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMETRIOU",
        "first_name": "JAMES",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2025049483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120259600",
            "state": "WY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "james.demetriou.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "19401 E 39th St S",
            "city": "Independence",
            "state": "MO",
            "country_code": "US",
            "postal_code": "640572308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.