Individual provider Active NPI

Olivia Rose Stewart, PA-C

  • Surgical Physician Assistant
  • Leawood, KS
National Provider Identifier
1952092769
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
15-02808 Issued in KS
Practice address
3651 College Blvd
Leawood, KS 66211-1910
Phone
(913) 319-7600
Fax
(913) 253-1702
NPI assigned
May 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 15-02808 KS Primary
Surgical Physician Assistant 363AS0400X 2023034169 MO

Addresses

Primary practice location

3651 College Blvd
Leawood, KS 66211-1910

Mailing address

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

Other names 1

  • Olivia Rose Moser Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240122001396 KS Practitioner - Physician Assistant 9537511985 Reassigns benefits to 1 organization
I20240122001625 MO Practitioner - Physician Assistant 9537511985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

201 NW R D Mize Rd
Blue Springs, MO 64014-2513
Phone (913) 319-7600

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

4320 Wornall Rd
Suite 610
Kansas City, MO 64111-3235
Phone (913) 319-7600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2023034169MOMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dickson Diveley Midwest Orthopaedic Clinic LLC CurrentSince Jan 2, 2024 Accepting new patients
Dickson Diveley Midwest Orthopaedic Clinic LLC CurrentSince Jan 2, 2024 Accepting new patients

Locations

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

17067 S Outer Rd
Ste 301
Belton, MO 64012
Phone (913) 257-6259

201 W Road Mize Rd
Ste 200
Blue Springs, MO 64014
Phone (913) 319-7600

4320 Wornall Rd
Ste 610
Kansas City, MO 64111
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 6

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": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1952092769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3651 COLLEGE BLVD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111910",
            "telephone_number": "913-319-7600",
            "fax_number": "913-253-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3651 COLLEGE BLVD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111910",
            "telephone_number": "913-319-7600",
            "fax_number": "913-253-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "OLIVIA",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KS",
            "license": "15-02808",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": "2023034169",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLIVIA",
            "last_name": "MOSER",
            "middle_name": "ROSE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Leawood, KS

Sources for this page

Verify at the official NPI Registry.