Individual provider Active NPI

Matthew J Buckneberg, CRNA

  • Certified Registered Nurse Anesthetist
  • Overland Park, KS
National Provider Identifier
1790084499
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
14104168 Issued in KS
Practice address
12300 Metcalf Ave
Anesthesia Dept
Overland Park, KS 66213-1324
Phone
(816) 389-6030
Fax
(816) 389-6034
NPI assigned
Mar 21, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2019006510 MO
Certified Registered Nurse Anesthetist 367500000X D184960 IA
Certified Registered Nurse Anesthetist 367500000X 14104168 KS Primary

Addresses

Primary practice location

12300 Metcalf Ave
Anesthesia Dept
Overland Park, KS 66213-1324

Mailing address

9233 Ward Pkwy
Suite 230
Kansas City, MO 64114-3366
Phone (816) 389-6030

Other practice location 1

4000 Cambridge St
Kansas City, KS 66160-8501
Phone (913) 588-1224

Other practice location 2

2700 Clay Edwards Dr Ste 240
North Kansas City, MO 64116-3254
Phone (816) 691-2021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO, IA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20110714000133 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416125638 Reassigns benefits to 5 organizations
I20191212000409 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416125638 Reassigns benefits to 2 organizations
I20250811002866 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7416125638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Kansas School of Med (KC/Wich/Sal), 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians
Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians
Anesthesia Associates of Kansas City PAGroup PAC ID 1951206168, 214 clinicians

Practice addresses (Care Compare)

1111 6TH Ave
Des Moines, IA 50314-2613
Phone (515) 247-3121

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

5721 W 119TH St
Menorah Medical Center
Overland Park, KS 66209-3722
Phone (913) 498-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
D184960IAMDCertified Registered Nurse Anesthetist
14104168KSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Anesthesia PC CurrentSince Aug 11, 2025 Accepting new patients
Capital Anesthesia Solutions of Missouri LLC CurrentSince Jul 1, 2025 Accepting new patients
Cep America - Anesthesia PC Current Accepting new patients
Rem Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 13, 2024 Accepting new patients
Cep America - Anesthesia PC CurrentSince Aug 11, 2025 Accepting new patients
Midwest Anesthesia Associates, PA Nurse Anesthetist, Certified Registered CurrentSince Oct 16, 2023 Accepting new patients
Kansas University Physicians Inc CurrentSince Sep 22, 2025 Accepting new patients
Meritas Health Corporation Current Accepting new patients
Meritas Health Corporation CurrentSince Oct 24, 2022 Accepting new patients
Kansas University Physicians Inc CurrentSince Sep 22, 2025 Accepting new patients
Kansas University Physicians Inc Current Accepting new patients
Anesthesia Associates of Kansas City PA CurrentSince Feb 27, 2023 Accepting new patients
Meritas Health Corporation CurrentSince Oct 24, 2022 Accepting new patients
Westport Anesthesia Services of Kansas PA Past Accepting new patients
Meritas Health Corporation Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1111 6th Ave
Des Moines, IA 50314
Phone (515) 247-3121

1755 59th Pl
West Des Moines, IA 50266
Phone (515) 247-4240

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

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

8935 State Ave
Kansas City, KS 66112
Phone (816) 389-6030

711 Marshall St
Leavenworth, KS 66048
Phone (913) 684-1100

7111 W 151st St
Overland Park, KS 66223
Phone (785) 403-0405

10730 Nall Ave
Ste 100
Overland Park, KS 66211
Phone (913) 428-9000

7840 W 165th St
Overland Park, KS 66223
Phone (913) 236-6455

15933 W 65th St
Shawnee, KS 66217
Phone (913) 239-0703

12300 Metcalf Ave
Shawnee Mission, KS 66213
Phone (913) 317-7000

10500 Quivira Rd
Shawnee Mission, KS 66215
Phone (913) 227-0565

5721 W 119th St
Shawnee Msn, KS 66209
Phone (913) 253-3000

9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230

9301 W 74th St
Ste 300
Shawnee Msn, KS 66204
Phone (913) 632-9300

2037 SE 29th St
Topeka, KS 66605
Phone (785) 267-9500

2316 E Meyer Blvd
Kansas City, MO 64132
Phone (816) 276-4360

4401 Wornall Rd
Kansas City, MO 64111
Phone (816) 932-2107

2700 Clay Edwards Dr
Ste 240
North Kansas City, MO 64116
Phone (816) 455-0681

3100 Oak Grove Rd
Rombauer, MO 63901
Phone (573) 776-2000

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 8

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": "1300665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1790084499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9233 WARD PKWY",
            "address_2": "SUITE 230",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641143366",
            "telephone_number": "816-389-6030",
            "fax_number": "816-389-6034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12300 METCALF AVE",
            "address_2": "ANESTHESIA DEPT",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662131324",
            "telephone_number": "816-389-6030",
            "fax_number": "816-389-6034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "KS",
            "postal_code": "661608501",
            "country_code": "US",
            "telephone_number": "913-588-1224",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2700 Clay Edwards Dr Ste 240",
            "address_purpose": "LOCATION",
            "city": "North Kansas City",
            "state": "MO",
            "postal_code": "641163254",
            "country_code": "US",
            "telephone_number": "816-691-2021",
            "fax_number": "816-346-7690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCKNEBERG",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-21",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2019006510",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D184960",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "14104168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.