MEDICARE: MATTHEW THOMAS MCLEAY 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	207RP1001X	Pulmonary Disease Physician	04-22824	KS
2	207RP1001X	Pulmonary Disease Physician	19414	NE

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	:	1265434328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW THOMAS MCLEAY M.D.

Provider Business Mailing Address
First Line	:	20375 W 151ST ST STE 451
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66061-7210
Country	:	US
Telephone Number	:	913-829-0446
Fax Number	:	913-829-7829

Provider Business Practice Location Address
First Line	:	20375 W 151ST ST STE 451
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66061-7210
Country	:	US
Telephone Number	:	913-829-0446
Fax Number	:	913-829-7829

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

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	10/26/2017

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