Active NPI
Kenneth R Velleman, M.D.
- Pediatric Anesthesiology Physician
- Columbia, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Anesthesiology Physician
- License
- 2021048633
- Practice address
- One Hospital Dr
Columbia, MO 65212-0001 - Phone
- (573) 882-2568
- Fax
- (855) 903-0985
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 44191 | TX | |
| Anesthesiology Physician | 207L00000X | 2021048633 | MO | |
| Pediatric Anesthesiology Physician | 207LP3000X | 44191 | TX | |
| Pediatric Anesthesiology Physician | 207LP3000X | 2021048633 | MO | Primary |
Addresses
Primary practice location
One Hospital Dr
Columbia, MO 65212-0001
Mailing address
PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 884-3300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3194524-01 | Medicaid | TX | |
| 64344492 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, TX, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Louisiana State University School of Medicine in New Orleans, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Hospital Dr
Columbia, MO 65212-0001
Phone (573) 882-4141
6742 N Frostwood Pkwy
Peoria, IL 61615-2402
Phone (309) 692-5393
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.23 of 100
- Quality
- 58.17
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.92
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021048633 | MO | MD | Anesthesiology Physician |
| 44191 | TX | MD | Pediatric Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Curators of the University of Missouri | Current | Accepting new patients | |
| Associated Anesthesiologists, S.C. | Anesthesiology | Current | Accepting new patients |
| Emergenchealth PLLC | Anesthesiology | Current | Accepting new patients |
| The Curators of the University of Missouri | Current | Accepting new patients | |
| Associated Anesthesiologists, SC | Anesthesiology | Current | Accepting new patients |
Locations
6742 N Frostwood Pkwy
Peoria, IL 61615
Phone (309) 692-5393
530neglen Oak Ave
Peoria, IL 61637
Phone (309) 692-5393
1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568
1100 Virginia Ave
Columbia, MO 65212
Phone (573) 882-2663
7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000
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.
-
- Multi-Specialty Clinic/Center
- Columbia, MO
- NPI 1235126921
-
- Anesthesiology Physician
- Peoria, IL
- NPI 1558306480
-
- Anesthesiology Physician
- Fort Worth, TX
- NPI 1467970897
-
- Plastic Surgery Physician
- Corpus Christi, TX
- NPI 1568658227
-
- Durable Medical Equipment & Medical Supplies
- Columbia, MO
- NPI 1356963201
-
- Anesthesiology Physician
- Peoria, IL
- NPI 1023612082
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jefferson City, MO
- NPI 1174597892
-
- General Acute Care Hospital
- Columbia, MO
- NPI 1699769901
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": "1641427200000",
"number": "1528178498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 843966",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641843966",
"telephone_number": "573-884-3300",
"fax_number": "573-884-0943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ONE HOSPITAL DR",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652120001",
"telephone_number": "573-882-2568",
"fax_number": "855-903-0985"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VELLEMAN",
"first_name": "KENNETH",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2022-01-06",
"certification_date": "2022-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "TX",
"license": "44191",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MO",
"license": "2021048633",
"primary": false
},
{
"code": "207LP3000X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pediatric Anesthesiology",
"state": "TX",
"license": "44191",
"primary": false
},
{
"code": "207LP3000X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pediatric Anesthesiology",
"state": "MO",
"license": "2021048633",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3194524-01",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64344492",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.