Provider Demographics
NPI:1972579894
Name:MIDWEST ORTHOPAEDICS, P.A.
Entity type:Organization
Organization Name:MIDWEST ORTHOPAEDICS, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SACK
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:913-362-8317
Mailing Address - Street 1:7450 KESSLER ST STE 140
Mailing Address - Street 2:
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2519
Mailing Address - Country:US
Mailing Address - Phone:913-362-8317
Mailing Address - Fax:913-362-0169
Practice Address - Street 1:7450 KESSLER ST STE 140
Practice Address - Street 2:
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204-2519
Practice Address - Country:US
Practice Address - Phone:913-362-8317
Practice Address - Fax:913-362-0169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-28
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100212290AMedicaid
KS2053003201Medicaid
CP8325OtherRAILROAD MEDICARE
CP8325OtherRAILROAD MEDICARE
KS2550000Medicare PIN