Individual provider Active NPI

Shervin Razavian, MD

  • Anesthesiology Physician
  • Lees Summit, MO
National Provider Identifier
1639462328
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2015013978 Issued in MO
Practice address
2100 SE Blue Pkwy
Lees Summit, MO 64063-1007
Phone
(816) 282-5000
Fax
(913) 428-2951
NPI assigned
May 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 94-07633 KS
Anesthesiology Physician 207L00000X 2015013978 MO Primary

Addresses

Primary practice location

2100 SE Blue Pkwy
Lees Summit, MO 64063-1007

Mailing address

8717 W 110TH St Ste 600
Overland Park, KS 66210-2126
Phone (913) 428-2900

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: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150716000383 KS Practitioner - Anesthesiology 6305159641 Reassigns benefits to 1 organization
I20150716000666 MO Practitioner - Anesthesiology 6305159641 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Nebraska College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates of Kansas City PAGroup PAC ID 1951206168, 214 clinicians

Practice addresses (Care Compare)

10730 Nall Ave
100 South Kansas City Surgicenter
Overland Park, KS 66211-1242
Phone (913) 901-9000

2100 SE Blue Pkwy
Lees Summit Medical Center
Lees Summit, MO 64063-1007
Phone (816) 282-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
94-07633KSMDAnesthesiology Physician
2015013978MOMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Kansas City PA Anesthesiology CurrentSince Jul 14, 2015 Accepting new patients

Locations

8717 W 110th St
Ste 600
Overland Park, KS 66210
Phone (913) 428-2910

10730 Nall Ave
Ste 100
Overland Park, KS 66211
Phone (913) 428-9000

2316 E Meyer Blvd
Kansas City, MO 64132
Phone (816) 276-4360

2100 SE Blue Pkwy
Lees Summit, MO 64063
Phone (816) 282-5175

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1306454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1639462328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8717 W 110TH ST STE 600",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102126",
            "telephone_number": "913-428-2900",
            "fax_number": "913-428-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 SE BLUE PKWY",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640631007",
            "telephone_number": "816-282-5000",
            "fax_number": "913-428-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZAVIAN",
        "first_name": "SHERVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KS",
            "license": "94-07633",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2015013978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

Verify at the official NPI Registry.