Individual provider Active NPI

Pierre Podrebarac, MD

  • Otolaryngology Physician
  • North Kansas City, MO
National Provider Identifier
1992781157
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
1999140782 Issued in MO
Practice address
2790 Clay Edwards Dr Ste 500
North Kansas City, MO 64116-3243
Phone
(816) 468-8820
Fax
(816) 468-8898
NPI assigned
Dec 20, 2005
Last updated
Jul 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 04-26208 KS
Otolaryngology Physician 207Y00000X 1999140782 MO Primary

Addresses

Primary practice location

2790 Clay Edwards Dr Ste 500
North Kansas City, MO 64116-3243

Mailing address

5101 College Blvd
Leawood, KS 66211-1614
Phone (816) 478-4200

Other identifiers 1

IdentifierTypeStateIssuer
204822506MedicaidMO

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
I20090427000183 MO Practitioner - Otolaryngology 4587619150 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Kansas School of Med (KC/Wich/Sal), 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meritas Health CorporationGroup PAC ID 6305748153, 492 clinicians

Practice addresses (Care Compare)

2800 Clay Edwards Dr
North Kansas City, MO 64116-3220
Phone (816) 691-2021

9411 N Oak Trfy
Kansas City, MO 64155-2262

Hospital & facility affiliations

  • NKC Health Hospital, North Kansas City, MO, CCN 260096

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-26208KSMDOtolaryngology Physician
1999140782MOMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meritas Health Corporation Otolaryngology CurrentSince Jan 1, 2010 Accepting new patients
Ascentist Physicians Group, LLC Otolaryngology CurrentSince Jan 1, 2024 Accepting new patients
Meritas Health Corporation CurrentSince Jan 1, 2010 Accepting new patients
Meritas Health Corporation Current Accepting new patients
Meritas Health Corporation Past Accepting new patients

Locations

5101 College Blvd
Overland Park, KS 66211

1000 Carondelet Dr
Kansas City, MO 64114
Phone (816) 942-4400

6450 N Chatham Ave
Kansas City, MO 64151
Phone (816) 740-5542

9411 N Oak Trfy
Ste 202
Kansas City, MO 64155
Phone (816) 421-0540

9411 N Oak Trfy
Ste LL1
Kansas City, MO 64155
Phone (816) 436-7072

4880 NE Goodview Cir
Lees Summit, MO 64064
Phone (816) 246-1456

2790 Clay Edwards Dr
Ste 500
North Kansas City, MO 64116
Phone (816) 472-5157

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1992781157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 COLLEGE BLVD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111614",
            "telephone_number": "816-478-4200",
            "fax_number": "816-875-2598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 CLAY EDWARDS DR STE 500",
            "city": "NORTH KANSAS CITY",
            "state": "MO",
            "postal_code": "641163243",
            "telephone_number": "816-468-8820",
            "fax_number": "816-468-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODREBARAC",
        "first_name": "PIERRE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "KS",
            "license": "04-26208",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "1999140782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204822506",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Kansas City, MO

Sources for this page

Verify at the official NPI Registry.