Individual provider Active NPI

Tyler Concannon, MD

  • Pain Medicine (Anesthesiology) Physician
  • Kansas City, MO
National Provider Identifier
1972094647
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
2023029524 Issued in MO
Practice address
4321 Washington St Ste 1200
Kansas City, MO 64111-5905
Phone
(816) 932-2932
Fax
(816) 932-5491
NPI assigned
May 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 94-09558 KS
Pain Medicine (Anesthesiology) Physician 207LP2900X 2023029524 MO Primary

Addresses

Primary practice location

4321 Washington St Ste 1200
Kansas City, MO 64111-5905

Mailing address

4321 Washington St Ste 1200
Kansas City, MO 64111-5905
Phone (816) 932-2932

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
I20230830002585 MO Practitioner - Anesthesiology 6709134059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Kansas School of Med (KC/Wich/Sal), 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

4321 Washington St
Suite 1200
Kansas City, MO 64111-5905
Phone (816) 932-2932

Hospital & facility affiliations

  • St Lukes Hospital of Kansas City Hospital, Kansas City, MO, CCN 260138
  • Saint Luke'S East Hospital Hospital, Lees Summit, MO, CCN 260216
  • Saint Lukes North Hospital Hospital, Kansas City, MO, CCN 260062
  • Saint Luke'S South Hospital Hospital, Overland Park, KS, CCN 170185

Merit-based Incentive Payment System (MIPS)

Final score
82.56 of 100Reported as group
Quality
76.07
Promoting interoperability
100
Improvement activities
40
Cost
65.79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2023029524MOMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke'S Physician Group Inc CurrentSince Aug 21, 2023 Accepting new patients

Locations

901 E 104th St
Kansas City, MO 64131
Phone (816) 502-7117

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Interoperability endpoints

  • Direct secure messaging: tconcannon630263@direct.saint-lukes.org

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.

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": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1972094647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 WASHINGTON ST STE 1200",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641115905",
            "telephone_number": "816-932-2932",
            "fax_number": "816-932-5491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 WASHINGTON ST STE 1200",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641115905",
            "telephone_number": "816-932-2932",
            "fax_number": "816-932-5491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONCANNON",
        "first_name": "TYLER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-29",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KS",
            "license": "94-09558",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MO",
            "license": "2023029524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.