Marta Hailu Kifle, NP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Independence, MO
NPI 1891402350 · NPPES record last updated Jan 17, 2025
Key facts
- NPI
- 1891402350
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 2022035981 (MO)
- Practice address
- 4429 S River Blvd
Independence, MO 64055-4659 - Phone
- (816) 768-0090
- NPI assigned
- Nov 3, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1643 NW 136 Ave
Sunrise, FL 33323-2857
1643 Nw136 Ave
BLDG H Suite 100
Sunrise, FL 33323
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO, KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221205002069 | MO | Practitioner - Nurse Practitioner | 7719356203 | Reassigns benefits to 4 organizations |
| I20250915001251 | KS | Practitioner - Nurse Practitioner | 7719356203 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022011310 | MO | MD | Marriage & Family Therapist |
| 53-81591-091 | KS | MD | Psychiatric/Mental Health Nurse Practitioner |
| 2022035981 | MO | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rediscover | Single Specialty | Current |
Accepting new patients |
| CS Pacs 3 Midwest LLC | Single Specialty | Current |
Accepting new patients |
| Ipc Pac Healthcare Services of Missouri Inc | Single Specialty | Current |
Accepting new patients |
| Kansas Post Acute Medical Services 1 PA | Single Specialty | Current |
Accepting new patients |
| Bridgeway Clinics LLC | Single Specialty | Current |
Accepting new patients |
| Rediscover | Current |
Accepting new patients | |
| NV Pacs 2 LLC | Single Specialty | Current |
Accepting new patients |
| Code 1 Wellness | Single Specialty | Past | Accepting new patients |
| Archway MH Clinics LLC | Psychiatric/Mental Health | Past | Accepting new patients |
Locations
1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325
17500 W 119th St
Olathe, KS 66061
Phone (913) 213-1686
601 E Main St
Pretty Prairie, KS 67570
Phone (620) 459-6822
800 Chambers Rd
Ferguson, MO 63135
Phone (314) 522-8100
4429 S River Blvd
Ste B
Independence, MO 64055
Phone (816) 768-0090
4429 S River Blvd
Independence, MO 64055
Phone (816) 373-0200
3660 Summit St
Kansas City, MO 64111
Phone (816) 531-1089
901 NE Independence Ave
Lees Summit, MO 64086
Phone (816) 246-1800
1555 NE Rice Rd
Lees Summit, MO 64086
Phone (816) 347-3069
1221 S Business Highway 13
Lexington, MO 64067
Phone (660) 259-4695
1600 E Rollins St
Moberly, MO 65270
Phone (660) 263-6887
1210 W Ashland St
Nevada, MO 64772
Phone (417) 667-5064
7001 Blue Ridge Blvd
Raytown, MO 64133
Phone (816) 988-2739
Interoperability endpoints
- marta.kifle.1@21565.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 53-81591-091 | KS | |
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | 2022035981 | MO | Yes |
Addresses
Primary practice location
4429 S River Blvd
Independence, MO 64055-4659
Mailing address
8613 NW 85TH Ter
Kansas City, MO 64153-1600
Phone (816) 673-6697
Other providers in Independence, MO
- Sofia S Khan
- Mohmmad Khoshneviszadeh
- Ashley Suzanne Kidd
- Elizabeth Rose Kieffer
- Jessica R Kientzy
- Mark Ray Killman
- Kim M Davies MD PA
- Yohan Kim
- Tiffany Kimbrough
- Jillian Moore King
All providers in Independence, MO · Psychiatric/Mental Health Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.