Angela Marie Pettus, DNP - Medicare Nurse Practitioner in Kansas City, MO

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Angela Marie Pettus, DNP is a medicare enrolled "Nurse Practitioner" in Kansas City, Missouri. Her current practice location is 4125 State Line Rd, Kansas City, Missouri. You can reach out to her office (for appointments etc.) via phone at (913) 284-1889.

Angela Marie Pettus is licensed to practice in Kansas (license number 53-81365-091) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1336873371.

Contact Information

Angela Marie Pettus, DNP
4125 State Line Rd,
Kansas City, MO 64111-4423
(913) 284-1889
Not Available

Map and Direction




Provider's Profile

Full NameAngela Marie Pettus
GenderFemale
SpecialityNurse Practitioner
Location4125 State Line Rd, Kansas City, Missouri
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1336873371
  • Provider Enumeration Date: 07/14/2022
  • Last Update Date: 06/03/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 7911389226
  • Enrollment ID: I20220803002237

Medical Identifiers

Medical identifiers for Angela Marie Pettus such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1336873371NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner 2022028087 (Missouri)Secondary
363LA2200XNurse Practitioner - Adult Health 53-81365-091 (Kansas)Secondary
363LA2200XNurse Practitioner - Adult Health 2022028087 (Missouri)Secondary
363LG0600XNurse Practitioner - Gerontology 53-81365-091 (Kansas)Secondary
363LG0600XNurse Practitioner - Gerontology 2022028087 (Missouri)Secondary
363L00000XNurse Practitioner 53-81365-091 (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. Angela Marie Pettus allows following entities to bill medicare on her behalf.
Entity NameSpine Pain And Rehab Associates Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1780157172
PECOS PAC ID: 6709125255
Enrollment ID: O20190228001593

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. Angela Marie Pettus 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 AddressPractice Location Address
Angela Marie Pettus, DNP
12310 W 54th St,
Shawnee, KS 66216-1402

Ph: () -		Angela Marie Pettus, DNP
4125 State Line Rd,
Kansas City, MO 64111-4423

Ph: (913) 284-1889

Reviews and Comments


Nurse Practitioner Nurses in Kansas City, MO

Natalie Christine Lickteig, FNP-BC
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Phone: 816-942-2438    
Sean M Ryan, FNP-C
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Jennifer Bitner, MSN, APRN, FNP-C
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Randyn Wertz, NP
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Phone: 816-523-9355    Fax: 816-523-9358
Sarah Wakat, FNP-C
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Practice Location: 4330 Wornall Rd Ste 2000, Kansas City, MO 64111
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Scarlett Wohlleber,
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Practice Location: 4321 Washington St Ste 3000, Kansas City, MO 64111
Phone: 816-932-3100    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.