NPIMap

Organization Active NPI

Kansas City Skin and Cancer Center, LLC

  • MOHS-Micrographic Surgery Physician
  • Kansas City, MO
National Provider Identifier
1669670964
Registry record updated May 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
2002002466 Issued in MO
Legal business name
KANSAS CITY SKIN AND CANCER CENTER, LLC
Practice address
5810 NW Barry Rd
Suite 100
Kansas City, MO 64154-1493
Phone
(816) 584-8100
Fax
(816) 584-8106
NPI assigned
Jul 7, 2007
Last updated
May 5, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2016

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

Authorized official

Name
Mark Andrew Cohen, MDNPI 1194785485
Title
Member
Phone
(786) 281-3827

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ND0101X 2002002466 MO Primary

Addresses

Primary practice location

5810 NW Barry Rd
Suite 100
Kansas City, MO 64154-1493

Mailing address

5810 NW Barry Rd
Suite 100
Kansas City, MO 64154-1493
Phone (816) 584-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070904000627 MO Part B Supplier - Clinic/Group Practice 5597858795 Receives reassigned benefits from 16 practitioners
Practice locations: Kansas City, MO
O20160506001891 KS Part B Supplier - Clinic/Group Practice 5597858795 Receives reassigned benefits from 7 practitioners
Practice locations: Shawnee Mission, KS

National Provider Directory

National Provider Directory

Locations

4400 Broadway Blvd
Ste 400
Kansas City, MO 64111
Phone (816) 584-8100

4400 Broadway Blvd
Ste 400A
Kansas City, MO 64111

5810 NW Barry Rd
Ste 100
Kansas City, MO 64154
Phone (816) 584-8100

8656 N Ambassador Dr
Kansas City, MO 64154
Phone (816) 584-8100

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1183766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462406400000",
    "number": "1669670964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5810 NW BARRY RD",
            "address_2": "SUITE 100",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641541493",
            "telephone_number": "816-584-8100",
            "fax_number": "816-584-8106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5810 NW BARRY RD",
            "address_2": "SUITE 100",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641541493",
            "telephone_number": "816-584-8100",
            "fax_number": "816-584-8106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANSAS CITY SKIN AND CANCER CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-07",
        "last_updated": "2016-05-05",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "786-281-3827",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MO",
            "license": "2002002466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.