MEDICARE: KANSAS CITY SURGICAL ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician

General Provider Information

NPI Number	:	1164234936
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KANSAS CITY SURGICAL ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	4606 W 87TH TER
Second Line	:
City	:	PRAIRIE VILLAGE
State	:	KS
Zip	:	66207-1922
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4606 W 87TH TER
Second Line	:
City	:	PRAIRIE VILLAGE
State	:	KS
Zip	:	66207-1922
Country	:	US
Telephone Number	:	913-593-9497
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JAMES HOWARD
Credential	:	MD
Telephone Number	:	913-593-9491

Provider Enumeration Date	:	01/21/2025
Last Update Date	:	01/29/2025

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