Omar Pulido Zepeda, PT, DPT

Individual provider Active NPI Physical Therapist · Roeland Park, KS

NPI 1902653686 · NPPES record last updated May 1, 2024

Key facts

NPI
1902653686
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
11-06971 (KS)
Practice address
5675 Roe Blvd Ste 240
Roeland Park, KS 66205-2515
Phone
(913) 632-4750
NPI assigned
May 1, 2024
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
11-06971KSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Shawnee Mission Medical Center, Inc. Past
since May 7, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11-06971 KS Yes

Addresses

Primary practice location

5675 Roe Blvd Ste 240
Roeland Park, KS 66205-2515

Mailing address

5675 Roe Blvd Ste 240
Roeland Park, KS 66205-2515

Other providers in Roeland Park, KS

All providers in Roeland Park, KS · Physical Therapist in Kansas

Sources for this page

Verify at the official NPI Registry.