MEDICARE: DR. TONY RIANPRAKAISANG M.D.

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	208U00000X	Clinical Pharmacology Physician	04-42268	KS
2	207P00000X	Emergency Medicine Physician	MD182028	OR
3	207P00000X	Emergency Medicine Physician	04-42268	KS
4	208U00000X	Clinical Pharmacology Physician	2020012812	MO
5	207P00000X	Emergency Medicine Physician	2020012812	MO

General Provider Information

NPI Number	:	1740693472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TONY RIANPRAKAISANG M.D.

Provider Business Mailing Address
First Line	:	3901 RAINBOW BLVD DEPT OF
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-0278
Country	:	US
Telephone Number	:	971-983-5260
Fax Number	:

Provider Business Practice Location Address
First Line	:	3901 RAINBOW BLVD DEPT OF
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-0278
Country	:	US
Telephone Number	:	913-588-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2014
Last Update Date	:	12/18/2025

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