Individual provider Active NPI

Punam Pam Shastri, DO

  • Pediatrics Physician
  • Kansas City, KS
National Provider Identifier
1487764544
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
05-27296 Issued in KS
Practice address
4000 Cambridge St
Kansas City, KS 66160-8501
Phone
(913) 588-6300
Fax
(913) 274-3515
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 05-27296 KS Primary

Addresses

Primary practice location

4000 Cambridge St
Kansas City, KS 66160-8501

Mailing address

2106 Olathe Blvd Ms 4004
Kansas City, KS 66160-7816
Phone (913) 588-6300

Other identifiers 5

IdentifierTypeStateIssuer
244966305MedicaidMO
370011203OtherRR MEDICARE
25039042OtherMOBCBS KANSAS CITY
646140OtherFIRSTGUARD
100314530AMedicaidKS

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
I20070308000444 KS Practitioner - Pediatric Medicine 2163525387 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05-27296KSMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc Pediatrics Current Accepting new patients
Kansas University Physicians Inc CurrentSince May 9, 2011 Accepting new patients
University of Kansas Hospital Authority CurrentSince Sep 13, 2014 Accepting new patients
University of Kansas Hospital Authority CurrentSince Sep 13, 2014 Accepting new patients
Kansas University Physicians Inc Pediatrics CurrentSince May 9, 2011 Accepting new patients
Kansas University Physicians Inc Past Accepting new patients

Locations

3901 Rainbow Blvd
Stop 4017
Kansas City, KS 66160
Phone (913) 588-6670

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

3901 Rainbow Blvd
Stop 4004
Kansas City, KS 66160
Phone (913) 588-6301

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

Interoperability endpoints

  • Direct secure messaging: pshastri7147@direct.kuha.org

Organizations & group practices 6

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1487764544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 OLATHE BLVD MS 4004",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661607816",
            "telephone_number": "913-588-6300",
            "fax_number": "913-274-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 CAMBRIDGE ST",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608501",
            "telephone_number": "913-588-6300",
            "fax_number": "913-274-3515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHASTRI",
        "first_name": "PUNAM",
        "middle_name": "PAM",
        "name_prefix": "Mrs.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "05-27296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "244966305",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "370011203",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KANSAS CITY",
            "identifier": "25039042",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTGUARD",
            "identifier": "646140",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100314530A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.