Trevena Moore, MD | |
2000 Olathe, Kansas City, KS 66160-1003 | |
(913) 588-5746 | |
(913) 274-3546 |
Full Name | Trevena Moore |
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Gender | Female |
Speciality | Pediatrics - Developmental - Behavioral Pediatrics |
Location | 2000 Olathe, Kansas City, Kansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1407893456 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 2003012943 (Missouri) | Secondary |
2080P0006X | Pediatrics - Developmental - Behavioral Pediatrics | 04-40273 (Kansas) | Primary |
Entity Name | Kansas University Physicians Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003858333 PECOS PAC ID: 8921911587 Enrollment ID: O20040401000328 |
Mailing Address | Practice Location Address |
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Trevena Moore, MD 2000 Olathe Blvd, Attn: Credentialing Office, Kansas City, KS 66160 Ph: (913) 588-5746 | Trevena Moore, MD 2000 Olathe, Kansas City, KS 66160-1003 Ph: (913) 588-5746 |
Carissa Lynn Stanton, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3901 Rainbow Blvd, Mail Stop 1037, Kansas City, KS 66160 Phone: 913-588-6329 | |
Mrs. Elizabeth Anne Pitts, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3901 Rainbow Blvd, Miller 2013, Kansas City, KS 66160 Phone: 913-588-6917 Fax: 913-588-6280 | |
Miss Susan Cannon, PT, DPT, MSED Pediatrics Medicare: Not Enrolled in Medicare Practice Location: Center For Child Health And Development, 3901 Rainbow Blvd., Mail Stop 4003, Kansas City, KS 66160 Phone: 913-588-5588 Fax: 913-588-5916 | |
Chaitali Nilkanth Mahajan, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 3901 Rainbow Blvd, Mailstop 4004, Kansas City, KS 66160 Phone: 913-588-6034 | |
Dr. David B Yu, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2040 Hutton Rd, Suite 102, Kansas City, KS 66109 Phone: 913-299-3700 Fax: 913-299-3050 | |
Dr. Kelly D Kreisler, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 3901 Rainbow Blvd, Mail Stop 4004, Kansas City, KS 66103 Phone: 913-588-5000 | |
Lisa S Gilmer, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 3901 Rainbow Blvd, 2026 Miller Mail Stop 4004, Kansas City, KS 66160 Phone: 913-588-6301 Fax: 913-588-6319 |