Individual provider Active NPI

Matthew Curtis Fieleke, M.D.

  • Family Medicine Physician
  • Independence, MO
National Provider Identifier
1467680900
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2022014480 Issued in MO
Practice address
3717 S Whitney Ave
Independence, MO 64055-6740
Phone
(913) 297-7472
NPI assigned
Jun 23, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 04-35558 KS
Family Medicine Physician 207Q00000X 2022014480 MO Primary

Addresses

Primary practice location

3717 S Whitney Ave
Independence, MO 64055-6740

Mailing address

3717 S Whitney Ave
Independence, MO 64055-6740
Phone (913) 297-7472

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
I20120831000537 KS Practitioner - Family Practice 8123275823 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-35558KSMDFamily Medicine Physician
2022014480MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spira Care, LLC Family Medicine CurrentSince Jul 21, 2024 Accepting new patients
Oak Street Health Physicians Group of Missouri, LLC Family Medicine CurrentSince Jun 20, 2022 Accepting new patients

Locations

3717 S Whitney Ave
Independence, MO 64055
Phone (816) 395-3520

16659 E 23rd St S
Independence, MO 64055
Phone (816) 688-6000

3843 Gravois Ave
Saint Louis, MO 63116
Phone (314) 888-0981

Interoperability endpoints

  • Direct secure messaging: matthew.fieleke.1@16552.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1467680900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3717 S WHITNEY AVE",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556740",
            "telephone_number": "913-297-7472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3717 S WHITNEY AVE",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556740",
            "telephone_number": "913-297-7472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELEKE",
        "first_name": "MATTHEW",
        "middle_name": "CURTIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-23",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-35558",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2022014480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.