Individual provider Active NPI

Chase Roger Pennewell, PA

  • Physician Assistant
  • Leawood, KS
National Provider Identifier
1619739604
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15-03086 Issued in KS
Practice address
4801 College Blvd
Leawood, KS 66211-1628
Phone
(913) 721-3387
Fax
(816) 875-2597
NPI assigned
Jan 25, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15-03086 KS Primary

Addresses

Primary practice location

4801 College Blvd
Leawood, KS 66211-1628

Mailing address

5101 College Blvd
Leawood, KS 66211-1614
Phone (913) 721-3387

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250709001763 KS Practitioner - Physician Assistant 8729592035 Reassigns benefits to 1 organization
I20250829002334 MO Practitioner - Physician Assistant 8729592035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascentist Physicians Group LLCGroup PAC ID 9335143759, 111 clinicians

Practice addresses (Care Compare)

2300 Hutton Rd
Suite 106
Kansas City, KS 66109-4424
Phone (913) 721-3387

2800 Clay Edwards Dr
Kansas City, MO 64116-3220
Phone (816) 478-4200

4550 W 109TH St
Suite 200
Overland Park, KS 66211-1354
Phone (913) 721-3387

4901 College Blvd
Leawood, KS 66211-1602
Phone (913) 721-3387

Hospital & facility affiliations

  • Ascentist Hospital LLC Hospital, Leawood, KS, CCN 170194
  • Menorah Medical Center Hospital, Overland Park, KS, CCN 170182
  • Providence Medical Center Hospital, Kansas City, KS, CCN 170146

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15-03086KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Health Specialists, LLC Past Accepting new patients
Northland Dermatology LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: chase.pennewell.1@12752.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.

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": "1706140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1619739604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 COLLEGE BLVD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111614",
            "telephone_number": "913-721-3387",
            "fax_number": "816-875-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 COLLEGE BLVD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111628",
            "telephone_number": "913-721-3387",
            "fax_number": "816-875-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNEWELL",
        "first_name": "CHASE",
        "middle_name": "ROGER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-25",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-03086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leawood, KS

Sources for this page

Verify at the official NPI Registry.