MEDICARE: MATTHEW SCAVUZZO

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	390200000X	Student in an Organized Health Care Education/Training Program		MO

General Provider Information

NPI Number	:	1871422105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW SCAVUZZO

Provider Business Mailing Address
First Line	:	8717 W 110TH ST STE 600
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66210-2126
Country	:	US
Telephone Number	:	913-438-2900
Fax Number	:	913-428-2951

Provider Business Practice Location Address
First Line	:	19600 E 39TH ST S
Second Line	:
City	:	INDEPENDENCE
State	:	MO
Zip	:	64057-2301
Country	:	US
Telephone Number	:	816-698-7000
Fax Number	:	913-428-2951

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

Provider Enumeration Date	:	05/14/2026
Last Update Date	:	05/14/2026

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Directions to “ MATTHEW SCAVUZZO ” Practice Location

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