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NPI Code Detail

MEDICARE: DR. DESIREE SUE GLEASON D.O.

MEDICARE: DR. DESIREE SUE GLEASON D.O.
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
1207R00000XInternal Medicine Physician05-49159KS
2207R00000XInternal Medicine Physician51023CO
3207R00000XInternal Medicine PhysicianTL3359CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1022562OTHERCOKAISER COMMERCIAL NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275862450
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DESIREE SUE GLEASON D.O.
Provider Business Mailing Address
First Line : 16575 W 119TH ST
Second Line :
City : OLATHE
State : KS
Zip : 66061-7770
Country : US
Telephone Number : 913-815-5508
Fax Number :
Provider Business Practice Location Address
First Line : 16575 W 119TH ST
Second Line :
City : OLATHE
State : KS
Zip : 66061-7770
Country : US
Telephone Number : 913-815-5508
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2009
Last Update Date : 02/13/2026

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