Active NPI
Pierre Podrebarac, MD
- Otolaryngology Physician
- North Kansas City, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 1999140782
- 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, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 204822506 | Medicaid | MO |
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
Enrollment records 1
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
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-26208 | KS | MD | Otolaryngology Physician |
| 1999140782 | MO | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meritas Health Corporation | Otolaryngology | Current | Accepting new patients |
| Ascentist Physicians Group, LLC | Otolaryngology | Current | Accepting new patients |
| Meritas Health Corporation | Current | 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.
-
dba Ascentist Healthcare
- Otolaryngology Physician
- Lee's Summit, MO
- NPI 1649206319
-
dba NKC Health
- Otolaryngology Physician
- North Kansas City, MO
- NPI 1336444918
-
- Neurology Physician
- Kansas City, MO
- NPI 1669323291
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Skilled Nursing Unit
- Skilled Nursing Facility
- North Kansas City, MO
- NPI 1437103215
Hospital
-
dba NKC Health
- General Acute Care Hospital
- North Kansas City, MO
- NPI 1629062799
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.