Individual provider Active NPI

Elliott Wityk, DPM

  • Foot & Ankle Surgery Podiatrist
  • Lee's Summit, MO
National Provider Identifier
1568922979
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
2008015501 Issued in MO
Practice address
2861 NE Independence Ave Ste 201
Lees Summit, MO 64064-2379
Phone
(816) 525-2840
Fax
(816) 525-2841
NPI assigned
Mar 21, 2019
Last updated
Dec 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 2008015501 MO Primary

Addresses

Primary practice location

2861 NE Independence Ave Ste 201
Lees Summit, MO 64064-2379

Mailing address

2861 NE Independence Ave Ste 201
Lees Summit, MO 64064-2379
Phone (816) 525-2840

Other practice location 1

11340 Nall Ave Ste 200
Leawood, KS 66211-1234
Phone (816) 525-2840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MO, KS3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20220720000471 TX Practitioner - Podiatry 2365823580 Reassigns benefits to 1 organization
I20240401000274 MO Practitioner - Podiatry 2365823580 Reassigns benefits to 1 organization
I20240617000518 KS Practitioner - Podiatry 2365823580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Orthopedics and Sports MedicineGroup PAC ID 8820370422, 45 clinicians

Practice addresses (Care Compare)

11340 Nall Ave
Suite 200
Overland Park, KS 66211-1234
Phone (816) 525-2840

121 N Dean Ave
Suite 101
Raymore, MO 64083-8398
Phone (816) 525-2840

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.64 of 100Reported as group
Quality
72.14
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue39
Removal of nail tissue20
Removal or shaving of skin growth11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2008015501MOMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Orthopedics and Sports Medicine CurrentSince May 11, 2024 Accepting new patients
Jeremiah Graff DPM P a Podiatrist CurrentSince Oct 30, 2023 Accepting new patients
Advanced Orthopedics and Sports Medicine CurrentSince May 11, 2024 Accepting new patients

Locations

11340 Nall Ave
Ste 200
Overland Park, KS 66211
Phone (913) 354-5020

505 S Hospital Dr
Paola, KS 66071
Phone (913) 232-9846

2861 NE Independence Ave
Ste 201
Lees Summit, MO 64064
Phone (660) 281-8118

121 N Dean Ave
Ste 101
Raymore, MO 64083

6901 Snider Plz
Ste 150
Dallas, TX 75205
Phone (214) 389-6475

7200 State Highway 161
Ste 120
Irving, TX 75039
Phone (214) 838-7171

2633 Dallas Pkwy
Ste 100
Plano, TX 75093
Phone (469) 562-1992

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1568922979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2861 NE INDEPENDENCE AVE STE 201",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640642379",
            "telephone_number": "816-525-2840",
            "fax_number": "816-525-2841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2861 NE INDEPENDENCE AVE STE 201",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640642379",
            "telephone_number": "816-525-2840",
            "fax_number": "816-525-2841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11340 Nall Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Leawood",
            "state": "KS",
            "postal_code": "662111234",
            "country_code": "US",
            "telephone_number": "816-525-2840",
            "fax_number": "816-525-2841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITYK",
        "first_name": "ELLIOTT",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "2008015501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

Verify at the official NPI Registry.