Individual provider Active NPI

Jesse Baltazar Merino, DNP, APRN, CPNP-PC

  • Pediatric Nurse Practitioner
  • Kansas City, MO
National Provider Identifier
1891417614
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
2022037518 Issued in MO
Practice address
2401 Gillham Rd
Kansas City, MO 64108-4619
Phone
(816) 234-3000
NPI assigned
Sep 19, 2022
Last updated
Feb 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 2022037518 MO Primary
Pediatric Nurse Practitioner 363LP0200X 53-82371-011 KS

Addresses

Primary practice location

2401 Gillham Rd
Kansas City, MO 64108-4619

Mailing address

2401 Gillham Rd
Kansas City, MO 64108-4619
Phone (816) 234-3000

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
I20221022000195 MO Practitioner - Family Practice 7214303882 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
53-82371-011KSMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Swope Health Services CurrentSince Oct 3, 2022 Accepting new patients
Swope Health Services Current Accepting new patients
Swope Health Services CurrentSince Oct 3, 2022 Accepting new patients
Swope Health Services Past Accepting new patients

Locations

17844 E 23rd St S
Independence, MO 64057
Phone (816) 257-9716

3801 Dr Martin Luther King Jr Blvd
Kansas City, MO 64130
Phone (816) 599-5500

6501 E 87th St
Kansas City, MO 64138
Phone (816) 444-8400

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1891417614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-234-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-234-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERINO",
        "first_name": "JESSE",
        "middle_name": "BALTAZAR",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-19",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2022037518",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "KS",
            "license": "53-82371-011",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.