Individual provider Active NPI

Matthew Wayne McEwen, MD

  • Dermatology Physician
  • Lees Summit, MO
National Provider Identifier
1730686643
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
2024001826 Issued in MO
Practice address
276 NE Tudor Rd
Lees Summit, MO 64086-5696
Phone
(816) 525-8500
NPI assigned
Apr 7, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 2024001826 MO Primary
MOHS-Micrographic Surgery Physician 207ND0101X 2024001826 MO

Addresses

Primary practice location

276 NE Tudor Rd
Lees Summit, MO 64086-5696

Mailing address

276 NE Tudor Rd
Lees Summit, MO 64086-5696
Phone (816) 525-8500

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
I20240520003379 MO Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 3779832399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Micrographic Dermatologic Surgery (MDS)
Education
University of Tennessee, HSC, College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lees Summit Dermatology Associates I PCGroup PAC ID 0446355317, 4 clinicians

Practice addresses (Care Compare)

276 NE Tudor Rd
Lees Summit, MO 64086-5696
Phone (816) 525-8500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision86
Removal of tissue1-10
Removal of skin lesions455
Removal of skin cancer323
Removal or shaving of skin growth1-10
Skin biopsy176

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024001826MOMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lee'S Summit Dermatology Associates I, PC CurrentSince Jul 1, 2024 Accepting new patients

Locations

276 NE Tudor Rd
Lees Summit, MO 64086
Phone (816) 524-1700

Interoperability endpoints

  • Direct secure messaging: mmcewen@directaddress.net

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1523059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1730686643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 NE TUDOR RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865696",
            "telephone_number": "816-525-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 NE TUDOR RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865696",
            "telephone_number": "816-525-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCEWEN",
        "first_name": "MATTHEW",
        "middle_name": "WAYNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-07",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MO",
            "license": "2024001826",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MO",
            "license": "2024001826",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

Verify at the official NPI Registry.