Individual provider Active NPI

Mary Lynn Engroff, P.T., P.A.-C

  • Physician Assistant
  • Blue Springs, MO
National Provider Identifier
1467528240
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2025028195 Issued in MO
Practice address
1131 W Main St
Blue Springs, MO 64015-3611
Phone
(816) 229-1941
Fax
(816) 229-7085
NPI assigned
Nov 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 2025028195 MO Primary

Addresses

Primary practice location

1131 W Main St
Blue Springs, MO 64015-3611

Mailing address

1131 W Main St
Blue Springs, MO 64015-3611
Phone (816) 229-1941

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
I20260424000985 MO Practitioner - Physician Assistant 8921275652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1131 W Main St
Blue Springs, MO 64015-3611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2025028195MOMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1164499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1467528240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 W MAIN ST",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640153611",
            "telephone_number": "816-229-1941",
            "fax_number": "816-229-7085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 W MAIN ST",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640153611",
            "telephone_number": "816-229-1941",
            "fax_number": "816-229-7085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGROFF",
        "first_name": "MARY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "P.T., P.A.-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-26",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2025028195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Springs, MO

Sources for this page

Verify at the official NPI Registry.