Individual provider Active NPI

Bruce S Liese, PHD

  • Psychologist
  • Kansas City, KS
National Provider Identifier
1770676223
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0616 Issued in KS
Practice address
3901 Rainbow Blvd
Ms 4017
Kansas City, KS 66160-0001
Phone
(913) 588-1944
Fax
(913) 588-2496
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 0616 KS Primary

Addresses

Primary practice location

3901 Rainbow Blvd
Ms 4017
Kansas City, KS 66160-0001

Mailing address

PO Box 411851
Kansas City, MO 64141-1851
Phone (913) 588-1944

Other identifiers 4

IdentifierTypeStateIssuer
498634500MedicaidMO
110150074OtherRAILROAD MEDICARE
11784036OtherBCBS KANSAS CITY
4957111501MedicaidKS

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101014000035 KS Practitioner - Clinical Psychologist 4688790140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
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

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

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

Hospital & facility affiliations

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 Philosophy

State licenses

LicenseStateTypeSpecialty
0616KSMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc CurrentSince Apr 1, 1996 Accepting new patients
Kansas University Physicians Inc CurrentSince Apr 1, 1996 Accepting new patients
Kansas University Physicians Inc Current Accepting new patients

Locations

3901 Rainbow Blvd
#4017
Kansas City, KS 66160
Phone (913) 588-1944

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

325 Maine St
Lawrence, KS 66044
Phone (785) 505-2988

Interoperability endpoints

  • Direct secure messaging: bliese40329@direct.kuha.org

Organizations & group practices 3

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1770676223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411851",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641411851",
            "telephone_number": "913-588-1944",
            "fax_number": "913-588-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD",
            "address_2": "MS 4017",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661600001",
            "telephone_number": "913-588-1944",
            "fax_number": "913-588-2496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIESE",
        "first_name": "BRUCE",
        "middle_name": "S",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "0616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "498634500",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110150074",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KANSAS CITY",
            "identifier": "11784036",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4957111501",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.