Individual provider Active NPI

Peter F Alfano, PA

  • Medical Physician Assistant
  • Overland Park, KS
National Provider Identifier
1619962495
Registry record updated Jan 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1501902 Issued in KS
Practice address
12140 Nall Ave Ste 100
Overland Park, KS 66209-2504
Phone
(816) 943-0706
Fax
(913) 451-1754
NPI assigned
Sep 16, 2005
Last updated
Jan 2, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1501902 KS Primary

Addresses

Primary practice location

12140 Nall Ave Ste 100
Overland Park, KS 66209-2504

Mailing address

12140 Nall Ave Ste 100
Overland Park, KS 66209-2504
Phone (816) 943-0706

Other identifiers 1

IdentifierTypeStateIssuer
1506330MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
432TNMDClinical Social Worker
1501902KSMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carthage Family Practice Specialists, PC Current Accepting new patients
Statland Clinic LTD Past Accepting new patients

Locations

133 Hospital Dr
Ste 500
Carthage, TN 37030
Phone (615) 735-0700

Interoperability endpoints

  • Direct secure messaging: peter.alfano@hca2.eclinicaldirectplus.com

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514851200000",
    "number": "1619962495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12140 NALL AVE STE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662092504",
            "telephone_number": "816-943-0706",
            "fax_number": "913-451-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12140 NALL AVE STE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662092504",
            "telephone_number": "816-943-0706",
            "fax_number": "913-451-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALFANO",
        "first_name": "PETER",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-16",
        "last_updated": "2018-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KS",
            "license": "1501902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1506330",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.