Individual provider Active NPI

Brian J Wittek, M.D.

  • Surgery Physician
  • North Kansas City, MO
National Provider Identifier
1881658631
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2001028987 Issued in MO
Practice address
2790 Clay Edwards Dr Ste 625
North Kansas City, MO 64116-3278
Phone
(816) 455-3990
Fax
(816) 455-5351
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2001028987 MO Primary

Addresses

Primary practice location

2790 Clay Edwards Dr Ste 625
North Kansas City, MO 64116-3278

Mailing address

2790 Clay Edwards Dr Ste 625
North Kansas City, MO 64116-3278
Phone (816) 455-3990

Other identifiers 1

IdentifierTypeStateIssuer
500558507MedicaidMO

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050718000109 MO Practitioner - General Surgery 7719913177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Creighton University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meritas Health CorporationGroup PAC ID 6305748153, 492 clinicians

Practice addresses (Care Compare)

2790 Clay Edwards Dr
Suite 625
North Kansas City, MO 64116-3278
Phone (816) 455-3990

Hospital & facility affiliations

  • NKC Health Hospital, North Kansas City, MO, CCN 260096

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)17
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Meritas Health Corporation CurrentSince Dec 1, 2007 Accepting new patients
Meritas Health Corporation Current Accepting new patients
Meritas Health Corporation Surgery CurrentSince Dec 1, 2007 Accepting new patients
Meritas Health Corporation Past Accepting new patients
Heartland Surgical Associates Surgery Past Accepting new patients
Meritas Health Corporation Past Accepting new patients
Meritas Health Corporation Past Accepting new patients

Locations

5400 N Oak Trfy
Ste 101
Kansas City, MO 64118
Phone (816) 455-3990

2790 Clay Edwards Dr
Ste 625
North Kansas City, MO 64116
Phone (816) 421-3115

2790 Clay Edwards Dr
Ste 600
North Kansas City, MO 64116
Phone (816) 561-3003

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

Organizations & group practices 7

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1881658631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 CLAY EDWARDS DR STE 625",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163278",
            "telephone_number": "816-455-3990",
            "fax_number": "816-455-5351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 CLAY EDWARDS DR STE 625",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163278",
            "telephone_number": "816-455-3990",
            "fax_number": "816-455-5351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTEK",
        "first_name": "BRIAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2001028987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500558507",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Kansas City, MO

Sources for this page

Verify at the official NPI Registry.