Organization Active NPI

Henry J. Kanarek M.D. PA

  • Allergy & Immunology Physician
  • Overland Park, KS
National Provider Identifier
1881781409
Registry record updated Aug 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
HENRY J. KANAREK M.D. PA
Practice address
4601 W 109TH Street
Suite 350
Overland Park, KS 66211-1349
Phone
(913) 451-8555
Fax
(913) 327-8553
NPI assigned
Oct 6, 2006
Last updated
Aug 16, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2012

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

Authorized official

Name
Ms. Kathy Michelle Riley
Title
Office Manager / Billing
Phone
(913) 451-8555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X NU Primary

Addresses

Primary practice location

4601 W 109TH Street
Suite 350
Overland Park, KS 66211-1349

Mailing address

4601 W. 109TH Street
Suite 350
Overland Park, KS 66211-1349
Phone (913) 451-8555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070313000362 KS Part B Supplier - Clinic/Group Practice 2567463490 Receives reassigned benefits from 3 practitioners
Practice locations: Overland Park, KS

National Provider Directory

National Provider Directory

Locations

4601 W 109th St
Ste 350
Overland Park, KS 66211
Phone (913) 451-8555

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345075200000",
    "number": "1881781409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 W. 109TH STREET",
            "address_2": "SUITE 350",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111349",
            "telephone_number": "913-451-8555",
            "fax_number": "913-327-8553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 W 109TH STREET",
            "address_2": "SUITE 350",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111349",
            "telephone_number": "913-451-8555",
            "fax_number": "913-327-8553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY J. KANAREK M.D. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2012-08-16",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OFFICE MANAGER / BILLING",
        "authorized_official_telephone_number": "913-451-8555",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NU",
            "license": null,
            "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 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.