Individual provider Active NPI

Colleen M Reisz, MD

  • Dermatology Physician
  • Kansas City, MO
National Provider Identifier
1720054364
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
105404 Issued in MO
Practice address
5330 N Oak Trfy
Ste 201
Kansas City, MO 64118-4699
Phone
(816) 454-0666
Fax
(816) 559-7118
NPI assigned
Feb 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 105404 MO Primary

Addresses

Primary practice location

5330 N Oak Trfy
Ste 201
Kansas City, MO 64118-4699

Mailing address

5330 N Oak Trfy
Ste 201
Kansas City, MO 64118-4699
Phone (816) 454-0666

Other identifiers 2

IdentifierTypeStateIssuer
070008137OtherMORAILROAD MEDICARE
070011545OtherKSRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 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
I20040809000421 MO Practitioner - DermatologyPractitioner - Internal Medicine 3375515620 Reassigns benefits to 1 organization
I20051018000777 KS Practitioner - Dermatology 3375515620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Kansas School of Med (KC/Wich/Sal), 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Medical Specialists PAGroup PAC ID 7517867203, shared by 2 NPIs, 13 clinicians

Practice addresses (Care Compare)

124 Westwoods Dr
Liberty, MO 64068-1181
Phone (816) 883-2965

5330 N Oak Trfy
Suite 201
Kansas City, MO 64118-4600
Phone (816) 454-0666

7450 Kessler St
Suite 130
Merriam, KS 66204-2550
Phone (816) 454-0666

8490 College Blvd
Overland Park, KS 66210-2123
Phone (816) 454-0666

Hospital & facility affiliations

  • Adventhealth Shawnee Mission Hospital, Shawnee Mission, KS, CCN 170104

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision18
Removal of skin lesions506
Removal or shaving of skin growth19
Skin biopsy244

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
105404MOMDDermatology Physician

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1720054364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5330 N OAK TRFY",
            "address_2": "STE 201",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641184699",
            "telephone_number": "816-454-0666",
            "fax_number": "816-454-1694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 N OAK TRFY",
            "address_2": "STE 201",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641184699",
            "telephone_number": "816-454-0666",
            "fax_number": "816-559-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISZ",
        "first_name": "COLLEEN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "105404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "070008137",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "070011545",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.