Active NPI
Peter F Alfano, PA
- Medical Physician Assistant
- Overland Park, KS
National Provider Identifier
1619962495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 1501902
- 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, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1506330 | Medicaid | TN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 432 | TN | MD | Clinical Social Worker |
| 1501902 | KS | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New 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
- 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.
-
- Family Medicine Physician
- Carthage, TN
- NPI 1508871302
-
- Internal Medicine Physician
- Overland Park, KS
- NPI 1487679098
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.