Individual provider Active NPI

Jared Burns, PA-C

  • Surgical Physician Assistant
  • Leawood, KS
National Provider Identifier
1902322019
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
15-02014 Issued in KS
Practice address
3651 College Blvd Ste 100a
Leawood, KS 66211-1910
Phone
(913) 319-7600
Fax
(913) 319-1702
NPI assigned
Aug 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 15-02014 KS Primary

Addresses

Primary practice location

3651 College Blvd Ste 100a
Leawood, KS 66211-1910

Mailing address

3651 College Blvd Ste 100a
Leawood, KS 66211-1910
Phone (913) 319-7600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20170912000238 KS Practitioner - Physician Assistant 0345513479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dickson Diveley Midwest Orthopaedic Clinic LLCGroup PAC ID 1153225479, 66 clinicians

Practice addresses (Care Compare)

3651 College Blvd
Leawood, KS 66211-1910
Phone (913) 319-7600

Hospital & facility affiliations

  • Kansas City Orthopaedic Institute Hospital, Leawood, KS, CCN 170188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15-02014KSMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dickson Diveley Midwest Orthopaedic Clinic LLC CurrentSince Jan 1, 2024 Accepting new patients
Dickson Diveley Midwest Orthopaedic Clinic LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

3651 College Blvd
Ste 100A
Leawood, KS 66211
Phone (913) 319-7500

3651 College Blvd
Ste 100B
Leawood, KS 66211
Phone (913) 362-0031

3651 W 111th St
Overland Park, KS 66211
Phone (800) 876-5958

10777 Nall Ave
Ste 300
Overland Park, KS 66211
Phone (913) 257-6259

7450 Kessler St
Ste 140
Shawnee Mission, KS 66204
Phone (913) 319-7600

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.

Hospital & facility affiliations 1

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": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1902322019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3651 COLLEGE BLVD STE 100A",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111910",
            "telephone_number": "913-319-7600",
            "fax_number": "913-319-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 COLLEGE BLVD STE 100A",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111910",
            "telephone_number": "913-319-7600",
            "fax_number": "913-319-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "JARED",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-21",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KS",
            "license": "15-02014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leawood, KS

Sources for this page

Verify at the official NPI Registry.