A4Me, Professional Association

Organization Active NPI Primary Care Clinic/Center · Shawnee Mission, KS

NPI 1972928935 · NPPES record last updated Feb 27, 2014

Key facts

NPI
1972928935
Entity type
Organization (NPI type 2)
Primary specialty
Primary Care Clinic/Center 261QP2300X
License
436887 (KS)
Legal business name
A4ME, PROFESSIONAL ASSOCIATION
Practice address
9100 W 74TH St
Shawnee Mission, KS 66204-4004
Phone
(913) 485-4139
NPI assigned
Feb 27, 2014
Organization subpart
No

Authorized official

Name
Maniza Ehtesham, MD
Title
Certifying Officer
Phone
(913) 485-4139

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in KS

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20140517000121 KS Part B Supplier - Clinic/Group Practice 0840413936 Receives reassigned benefits from 1 practitioner
Practice locations: Overland Park, KS
O20181106001387 KS DME Supplier - Physician - General Practice 0840413936 Practice locations: Overland Park, KS

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 436887 KS Yes
Sleep Disorder Diagnostic Clinic/Center 261QS1200X

Addresses

Primary practice location

9100 W 74TH St
Shawnee Mission, KS 66204-4004

Mailing address

15400 Larsen St
Overland Park, KS 66221-6807

Other providers in Shawnee Mission, KS

All providers in Shawnee Mission, KS · Primary Care Clinic/Center in Kansas

Sources for this page

Verify at the official NPI Registry.