Individual provider Active NPI

Amanda Rae Merino, DNP

  • Family Nurse Practitioner
  • Lenexa, KS
National Provider Identifier
1720505167
Registry record updated Sep 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
53-77832-041 Issued in KS
Practice address
23401 Prairie Star Pkwy Ste B-300
Lenexa, KS 66227-7268
Phone
(913) 677-6319
Fax
(913) 677-1540
NPI assigned
Aug 26, 2017
Last updated
Sep 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 53-77832-041 KS Primary

Addresses

Primary practice location

23401 Prairie Star Pkwy Ste B-300
Lenexa, KS 66227-7268

Mailing address

3726 N 153Rd Ter
Basehor, KS 66007-3008
Phone (913) 706-7434

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: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180223001252 KS Practitioner - Nurse Practitioner 3173884632 Reassigns benefits to 1 organization
I20190509002334 MO Practitioner - Nurse Practitioner 3173884632

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Kansas School of Med (KC/Wich/Sal), 2017
Medicare assignment
May accept Medicare assignment
Group practices
KC Bariatric LLCGroup PAC ID 3375600182, 16 clinicians

Practice addresses (Care Compare)

23401 Prairie Star Pkwy
Suite 300
Lenexa, KS 66227-7246

23401 Prairie Star Pkwy
Suite 300
Lenexa, KS 66227-7268

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
53-77832-041KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
KC Bariatric, LLC CurrentSince Sep 30, 2023 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1503705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693785600000",
    "number": "1720505167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3726 N 153RD TER",
            "city": "BASEHOR",
            "state": "KS",
            "postal_code": "660073008",
            "telephone_number": "913-706-7434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23401 PRAIRIE STAR PKWY STE B-300",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662277268",
            "telephone_number": "913-677-6319",
            "fax_number": "913-677-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERINO",
        "first_name": "AMANDA",
        "middle_name": "RAE",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-26",
        "last_updated": "2023-09-04",
        "certification_date": "2023-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-77832-041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenexa, KS

Sources for this page

Verify at the official NPI Registry.