Stewart R Grote, DO
Individual provider Active NPI Internal Medicine Physician · Lansing, KS
NPI 1902898968 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1902898968
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 05-22108 (KS)
- Practice address
- 712 1St Ter
Lansing, KS 66043-1704 - Phone
- (913) 727-6000
- Fax
- (913) 351-1346
- NPI assigned
- Aug 16, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150716000878 | KS | Order and Referring Only - Internal Medicine |
5799675583 |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05-22108 | KS | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prime Healthcare Physician Services - Providence Inc | Internal Medicine | Past | Accepting new patients |
| Providence Care Inc | Internal Medicine | Past | Accepting new patients |
Interoperability endpoints
- stewart.grote@46450661392388.direct.elationemr.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 05-22108 | KS | Yes |
Addresses
Primary practice location
712 1St Ter
Lansing, KS 66043-1704
Mailing address
712 1St Ter
Lansing, KS 66043-1704
Phone (913) 727-6000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13565015 | Other | BCBS KC | |
| 100543 | Other | BC KS | |
| 2456370802 | Medicaid | KS |
Other providers in Lansing, KS
- Dawn Gnuthake
- Surem Saharaim Gomez
- Taylor Lyn Grabowski
- Erin D. Grosshuesch
- Catherine Martin Grote
- Janice M Gunter
- Kimberly Guthrie
- Hanger Prosthetics & Orthotics East Inc
- Sabine Anja Harrell
- Jana Harris
All providers in Lansing, KS · Internal Medicine Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.