Christopher R Bartalos, DO
Individual provider Active NPI Gastroenterology Physician · Lees Summit, MO
NPI 1720076607 · NPPES record last updated Jul 22, 2013
Key facts
- NPI
- 1720076607
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gastroenterology Physician 207RG0100X
- License
- 2004008628 (MO)
- Practice address
- 20 NE Saint Lukes Blvd Ste 330
Lees Summit, MO 64086-6001 - Phone
- (816) 554-3838
- Fax
- (816) 554-1634
- NPI assigned
- Oct 13, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO, KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050616000749 | MO | Practitioner - Gastroenterology |
8426092743 | Reassigns benefits to 1 organization |
| I20150922001104 | KS | Practitioner - Gastroenterology | 8426092743 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Digestive Health Specialists, LLC | Gastroenterology | Current |
Accepting new patients |
Locations
7820 W 165th St
Overland Park, KS 66223
Phone (913) 232-9846
615 W Nursery St
Butler, MO 64730
Phone (660) 200-2004
17501 E US Highway 40
Ste 213A
Independence, MO 64055
Phone (816) 478-7887
3800 S Whitney Ave
Ste 100
Independence, MO 64055
110 NE Saint Lukes Blvd
Ste 530
Lees Summit, MO 64086
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 2004008628 | MO | |
| Gastroenterology Physician | 207RG0100X | 2004008628 | MO | Yes |
Addresses
Primary practice location
20 NE Saint Lukes Blvd Ste 330
Lees Summit, MO 64086-6001
Mailing address
20 NE Saint Luke'S Blvd Suite 330
Lee'S Summit, MO 64086-0172
Phone (816) 554-3838
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 207184706 | Medicaid | MO |
Other providers in Lees Summit, MO
- Krista Barnes
- Jennifer Barnett-Garner
- Jennifer Lynn Barnett
- Michelle Lynn Barnett
- Sara Barnett
- Danielle N Barton
- Matthew S Barton
- Judy Bartshe
- Madeline Bassett
- Emma Michelle Bauer
All providers in Lees Summit, MO · Gastroenterology Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.