Provider Demographics
NPI:1073546578
Name:PATENAUDE, BART C (MD)
Entity type:Individual
Prefix:DR
First Name:BART
Middle Name:C
Last Name:PATENAUDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 E 54TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-2861
Mailing Address - Country:US
Mailing Address - Phone:816-519-3013
Mailing Address - Fax:
Practice Address - Street 1:15 E 54TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64110-2453
Practice Address - Country:US
Practice Address - Phone:816-519-3013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-32490207Y00000X
MO2008016031207Y00000X
KS0432490208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS210556OtherHEALTH PARTNERS OF KANSAS
KS000OtherCENTURY HEALTH SOLUTIONS
KS000OtherPREFERRED HEALTH SYSTEMS
KS000OtherTRICARE
KS000OtherCIGNA
KS000OtherCOVENTRY
KS000OtherHUMANA/CHOICE CARE
KS000OtherINDIAN HEALTH SERVICES
KS000OtherMULTIPLAN
KS200608340DMedicaid
KS000OtherCHILDREN'S MERCY
KS000OtherUNITED HEALTH CARE
KS1073546578OtherBCBS OF KANSAS
KS110832007Medicare PIN