MEDICARE: DR. BRIAN W. BALANOFF MD

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	207L00000X	Anesthesiology Physician	01047392	IN
2	207L00000X	Anesthesiology Physician	0431503	KS
3	207L00000X	Anesthesiology Physician	2023043761	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00285427	OTHER	KS	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841284114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN W. BALANOFF MD

Provider Business Mailing Address
First Line	:	14613 FARLEY ST
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66221-9672
Country	:	US
Telephone Number	:	913-907-7316
Fax Number	:

Provider Business Practice Location Address
First Line	:	1318 E 104TH ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-4504
Country	:	US
Telephone Number	:	816-256-5200
Fax Number	:

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

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	03/31/2026

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