NPIMap

Organization Active NPI

Monarch Plastic Surgery P a

  • Specialist
  • Leawood, KS
National Provider Identifier
1710934245
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MONARCH PLASTIC SURGERY P A
Practice address
4801 W 135TH St
Leawood, KS 66224-8901
Phone
(913) 663-3838
Fax
(913) 663-4434
NPI assigned
May 29, 2006
Last updated
Jul 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Authorized official

Name
Dustin Carrillo
Title
Ceo
Phone
(913) 663-3838

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

4801 W 135TH St
Leawood, KS 66224-8901

Mailing address

4801 W 135TH St
Leawood, KS 66224-8901
Phone (913) 663-3838

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080806000204 MO Part B Supplier - Clinic/Group Practice 6204900475 Receives reassigned benefits from 8 practitioners
Practice locations: Kansas City, MO
O20080806000241 KS Part B Supplier - Clinic/Group Practice 6204900475 Receives reassigned benefits from 10 practitioners
Practice locations: Overland Park, KS

National Provider Directory

National Provider Directory

Locations

4801 W 135th St
Overland Park, KS 66224
Phone (913) 663-3838

9401 N Oak Trfy
Kansas City, MO 64155
Phone (816) 350-6812

9401 N Oak Trfy
Ste 100
Kansas City, MO 64155
Phone (816) 436-1700

9501 N Oak Trfy
Ste 202
Kansas City, MO 64155
Phone (816) 436-3262

258 N E Tudor
Lees Summit, MO 64086
Phone (913) 663-3838

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1148860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784246400000",
    "number": "1710934245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 W 135TH ST",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662248901",
            "telephone_number": "913-663-3838",
            "fax_number": "913-663-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 W 135TH ST",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662248901",
            "telephone_number": "913-663-3838",
            "fax_number": "913-663-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONARCH PLASTIC SURGERY P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-29",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A",
        "authorized_official_last_name": "CARRILLO",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "913-663-3838"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leawood, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; 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.