Healthcare Provider Details

I. General information

NPI: 1487304150
Provider Name (Legal Business Name): JOSEPH CASELLA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2022
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 NE SAINT LUKES BLVD
LEES SUMMIT MO
64086-6000
US

IV. Provider business mailing address

901 E 104TH ST
KANSAS CITY MO
64131-4517
US

V. Phone/Fax

Practice location:
  • Phone: 816-932-6379
  • Fax:
Mailing address:
  • Phone: 816-932-3679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2026018634
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: