Dr Shane Douglas Kentopp, PHD is a medicare enrolled "Psychologist" provider in Kansas City, Kansas. His current practice location is
3901 Rainbow Blvd, Kansas City, Kansas. You can reach out to his office (for appointments etc.) via phone at
(913) 588-5000.
Dr Shane Douglas Kentopp is licensed to practice in Kansas (license number 03250) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1184056905.
Healthcare Provider's Profile
| Full Name | Dr Shane Douglas Kentopp |
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| Gender | Male |
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| Speciality | Psychologist |
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| Location | 3901 Rainbow Blvd, Kansas City, Kansas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1184056905
- Provider Enumeration Date: 08/02/2013
- Last Update Date: 08/17/2023
Medicare PECOS Information:
- PECOS PAC ID: 3274997390
- Enrollment ID: I20230907003680
Medical Identifiers
Medical identifiers for Dr Shane Douglas Kentopp such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1184056905 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | 03250 (Kansas) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Shane Douglas Kentopp allows following entities to bill medicare on his behalf.
| Entity Name | Kansas University Physicians Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1003858333
PECOS PAC ID: 8921911587
Enrollment ID: O20040401000328 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Shane Douglas Kentopp is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Shane Douglas Kentopp, PHD
3901 Rainbow Blvd,
Kansas City, KS 66160-8500
Ph: () - | Dr Shane Douglas Kentopp, PHD
3901 Rainbow Blvd,
Kansas City, KS 66160-6214
Ph: (913) 588-5000 |
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