Provider Demographics
NPI:1033203971
Name:ROMITO, JOHN A (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:ROMITO
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 1:12200 W 106TH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2305
Mailing Address - Country:US
Mailing Address - Phone:913-541-8897
Mailing Address - Fax:913-541-9135
Practice Address - Street 1:12200 W 106TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2305
Practice Address - Country:US
Practice Address - Phone:913-541-8897
Practice Address - Fax:913-541-9135
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0415554207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100200530DMedicaid
KS100200530AMedicaid
KS10816012OtherBCBS
MO1033203971Medicaid
KS6306624Medicare ID - Type Unspecified
KS100200530DMedicaid
KS100200530AMedicaid
MO1033203971Medicaid