MEDICARE: DR. REBECCA SUE HODOS 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	207R00000X	Internal Medicine Physician	04-30362	KS
2	208M00000X	Hospitalist Physician	118565	MO
3	207R00000X	Internal Medicine Physician	118565	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	7445001	OTHER	AETNA
6	370510	OTHER	FIRST GUARD
7	25932022	OTHER	BCBS

General Provider Information

NPI Number	:	1992798094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REBECCA SUE HODOS M.D.

Provider Business Mailing Address
First Line	:	9411 N OAK TRFY STE LL1
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64155-2262
Country	:	US
Telephone Number	:	816-691-1655
Fax Number	:	816-455-5294

Provider Business Practice Location Address
First Line	:	2700 CLAY EDWARDS DR
Second Line	:	SUITE 240
City	:	NORTH KANSAS CITY
State	:	MO
Zip	:	64116-3251
Country	:	US
Telephone Number	:	816-455-0681
Fax Number	:	816-455-5294

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

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	05/30/2023

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Directions to “ DR. REBECCA SUE HODOS M.D.” Practice Location

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