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	2023043761	MO
3	207L00000X	Anesthesiology Physician	0431503	KS

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	:	PO BOX 843018
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64184-3018
Country	:	US
Telephone Number	:	913-782-2292
Fax Number	:	913-782-2381

Provider Business Practice Location Address
First Line	:	20375 W 151ST ST
Second Line	:	SUITE 306
City	:	OLATHE
State	:	KS
Zip	:	66061-5306
Country	:	US
Telephone Number	:	913-782-2292
Fax Number	:	913-782-2381

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

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	05/01/2025

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Directions to “ DR. BRIAN W. BALANOFF MD” Practice Location

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