Individual provider Active NPI

Derek W Barnard, PA-C

  • Surgical Physician Assistant
  • Leawood, KS
National Provider Identifier
1740216522
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
15-0074 Issued in KS
Practice address
3651 College Blvd
Leawood, KS 66211-1910
Phone
(913) 319-7600
Fax
(913) 253-1702
NPI assigned
Jun 24, 2006
Last updated
Jul 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 2024022101 MO
Surgical Physician Assistant 363AS0400X 15-0074 KS Primary

Addresses

Primary practice location

3651 College Blvd
Leawood, KS 66211-1910

Mailing address

3651 College Blvd
Leawood, KS 66211-1910
Phone (913) 319-7600

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
I20060811000405 KS Practitioner - Physician Assistant 6002819018 Reassigns benefits to 1 organization
I20240624001709 MO Practitioner - Physician Assistant 6002819018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3651 College Blvd
Leawood, KS 66211-1910
Phone (913) 319-7600

4320 Wornall Rd
Suite 610
Kansas City, MO 64111-3235
Phone (913) 319-7600

7450 Kessler St
Suite 140
Merriam, KS 66204-2550
Phone (913) 319-7600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
00745KSMDBehavioral Analyst
15-0074KSMDSurgical Physician Assistant
2024022101MOMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dickson Diveley Midwest Orthopaedic Clinic LLC CurrentSince Apr 15, 2024 Accepting new patients
Dickson Diveley Midwest Orthopaedic Clinic LLC CurrentSince Apr 15, 2024 Accepting new patients

Locations

10777 Nall Ave
Ste 300
Overland Park, KS 66211
Phone (913) 257-6259

3651 W 111th St
Overland Park, KS 66211
Phone (800) 876-5958

7450 Kessler St
Ste 140
Shawnee Mission, KS 66204
Phone (913) 362-8317

17067 S Outer Rd
Ste 301
Belton, MO 64012
Phone (913) 257-6259

201 W Road Mize Rd
Ste 200
Blue Springs, MO 64014

4320 Wornall Rd
Ste 610
Kansas City, MO 64111
Phone (816) 531-5757

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

Hospital & facility affiliations 4

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": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1740216522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3651 COLLEGE BLVD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111910",
            "telephone_number": "913-319-7600",
            "fax_number": "913-253-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 COLLEGE BLVD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111910",
            "telephone_number": "913-319-7600",
            "fax_number": "913-253-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNARD",
        "first_name": "DEREK",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": "2024022101",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KS",
            "license": "15-0074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leawood, KS

Sources for this page

Verify at the official NPI Registry.