Individual provider Active NPI

Sara Diane Peterson, DO

  • Family Medicine Physician
  • Kansas City, KS
National Provider Identifier
1740860436
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
05-49857 Issued in KS
Practice address
4000 Cambridge St
Kansas City, KS 66160-8500
Phone
(913) 588-1908
NPI assigned
Apr 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 05-49857 KS Primary

Addresses

Primary practice location

4000 Cambridge St
Kansas City, KS 66160-8500

Mailing address

3901 Rainbow Blvd # Ms 1060
Kansas City, KS 66160-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20240829001878 KS Practitioner - Family Practice 4880097427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians

Practice addresses (Care Compare)

11300 Corporate Ave
Suite 342
Lenexa, KS 66219-1368

20375 W 151St St
Olathe, KS 66160-0001
Phone (913) 588-1227

3901 Rainbow Blvd
Kansas City, KS 66160-0001
Phone (913) 588-7775

3901 Rainbow Blvd
Kansas City, KS 66160-8500
Phone (913) 588-7013

4000 Cambridge St
Kansas City, KS 66160-0001
Phone (913) 588-1227

4000 Cambridge St
Kansas City, KS 66160-8500

4000 Cambridge St
Suite G600
Kansas City, KS 66160-8501
Phone (913) 588-1227

Hospital & facility affiliations

  • University of Kansas Hospital Hospital, Kansas City, KS, CCN 170040

Merit-based Incentive Payment System (MIPS)

Final score
92.91 of 100Reported as apm
Quality
77.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05-49857KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc CurrentSince Aug 15, 2024 Accepting new patients
Kansas University Physicians Inc Family Medicine CurrentSince Aug 15, 2024 Accepting new patients
Kansas University Physicians Inc Family Medicine Current Accepting new patients
Kansas University Physicians Inc Past Accepting new patients
University of Kansas Hospital Authority Past Accepting new patients

Locations

3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005

4000 Cambridge St
Kansas City, KS 66160
Phone (913) 588-0000

3901 Rainbow Blvd
#1060
Kansas City, KS 66160
Phone (913) 588-5276

11300 Corporate Ave
Ste 342
Lenexa, KS 66219
Phone (913) 574-0425

Interoperability endpoints

  • Direct secure messaging: speterson673515@direct.kuha.org

Organizations & group practices 5

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 2

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": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1740860436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD # MS 1060",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 CAMBRIDGE ST",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608500",
            "telephone_number": "913-588-1908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "SARA",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-08",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "05-49857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.