Individual provider Active NPI

Kevin Meilak, MD

  • Pediatrics Physician
  • Lees Summit, MO
National Provider Identifier
1720584600
Registry record updated Sep 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2021018943 Issued in MO
Practice address
995 SW 34TH St
Lees Summit, MO 64082-4093
Phone
(816) 524-5600
NPI assigned
Apr 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2021018943 MO Primary

Addresses

Primary practice location

995 SW 34TH St
Lees Summit, MO 64082-4093

Mailing address

995 SW 34TH St
Lees Summit, MO 64082-4093
Phone (816) 524-2697

Other practice location 1

2401 Gillham Rd
Kansas City, MO 64108
Phone (816) 234-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20180710003950 MO Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 2567718224

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021018943MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Mercy-Community Choice Pediatrics Pediatrics Past Accepting new patients
Saint Lukes East Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kevin.meilak.1@25804.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/25804/brand/1/csg/1/fhir/r4
  • FHIR API: https://epicmobile.corp.saint-lukes.org/FHIRPROXY/api/FHIR/R4

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.

NPI Registry JSON

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

{
    "created_epoch": "1522540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630886400000",
    "number": "1720584600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 SW 34TH ST",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640824093",
            "telephone_number": "816-524-2697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 SW 34TH ST",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640824093",
            "telephone_number": "816-524-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 Gillham Rd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "64108",
            "country_code": "US",
            "telephone_number": "816-234-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEILAK",
        "first_name": "KEVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-01",
        "last_updated": "2021-09-06",
        "certification_date": "2021-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2021018943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

Verify at the official NPI Registry.