Individual provider Active NPI

Stefan Eichenauer, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Kansas City, MO
National Provider Identifier
1598021479
Registry record updated Nov 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
2016023767 Issued in MO
Practice address
4400 Broadway
Suite 540
Kansas City, MO 64111-3498
Phone
(816) 531-4080
Fax
(816) 932-6211
NPI assigned
Apr 5, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 2016023767 MO Primary
Physical Medicine & Rehabilitation Physician 208100000X 04-39027 KS

Addresses

Primary practice location

4400 Broadway
Suite 540
Kansas City, MO 64111-3498

Mailing address

901 E 104TH St
Kansas City, MO 64131-4517
Phone (816) 502-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20240927000191 IL Practitioner - Physical Medicine and Rehabilitation 5890094965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty Group 2,123 clinicians

Practice addresses (Care Compare)

2200 Fort Jesse Rd
Suite 200
Normal, IL 61761-6289
Phone (309) 661-6240

2500 W Reynolds St
Pontiac, IL 61764-9774

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

  • Saint James Hospital Hospital, Pontiac, IL, CCN 140161
  • Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110
  • St Joseph Medical Center Hospital, Bloomington, IL, CCN 140162
  • Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

Merit-based Incentive Payment System (MIPS)

Final score
79.28 of 100Reported as group
Quality
73.83
Improvement activities
40
Cost
45.57

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-39027KSMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Sep 16, 2024 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

2200 Fort Jesse Rd
Ste 200
Normal, IL 61761
Phone (309) 661-6240

2200 Fort Jesse Rd
Ste 210
Normal, IL 61761
Phone (309) 661-6230

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

2500 W Reynolds St
Ste 210
Pontiac, IL 61764
Phone (309) 661-6230

702 S Rittenhouse Dr
Pontiac, IL 61764
Phone (309) 662-9461

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.

Hospital & facility affiliations 3

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": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510099200000",
    "number": "1598021479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E 104TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641314517",
            "telephone_number": "816-502-7000",
            "fax_number": "816-932-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 BROADWAY",
            "address_2": "SUITE 540",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113498",
            "telephone_number": "816-531-4080",
            "fax_number": "816-932-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICHENAUER",
        "first_name": "STEFAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-05",
        "last_updated": "2017-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "2016023767",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "KS",
            "license": "04-39027",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.