Individual provider Active NPI

Austin Shandley, PA

  • Physician Assistant
  • Kansas City, MO
National Provider Identifier
1881085066
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
00000000 Issued in MO
Practice address
8656 N Ambassador Dr
Kansas City, MO 64154-2558
Phone
(816) 584-8100
Fax
(816) 584-8106
NPI assigned
Feb 10, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 00000000 MO Primary

Addresses

Primary practice location

8656 N Ambassador Dr
Kansas City, MO 64154-2558

Mailing address

1419 Village Dr
Saint Joseph, MO 64506-2459
Phone (816) 364-1507

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150909002283 MO Practitioner - Physician Assistant 9335456243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas City Skin and Cancer Center LLCGroup PAC ID 5597858795, 15 clinicians

Practice addresses (Care Compare)

4400 Broadway Blvd
Suite 400
Kansas City, MO 64111-3342
Phone (816) 584-8100

8656 N Ambassador Dr
Kansas City, MO 64154-2558
Phone (816) 584-8100

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
00000000MOMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Harrison County Community Hospital District Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1423526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1881085066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 VILLAGE DR",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062459",
            "telephone_number": "816-364-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8656 N AMBASSADOR DR",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641542558",
            "telephone_number": "816-584-8100",
            "fax_number": "816-584-8106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANDLEY",
        "first_name": "AUSTIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-10",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "00000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.