Provider Demographics
NPI:1053323493
Name:PIMENTEL, RHEA C (MD)
Entity Type:Individual
Prefix:
First Name:RHEA
Middle Name:C
Last Name:PIMENTEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 CAMBRIDGE ST STE G600
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8501
Mailing Address - Country:US
Mailing Address - Phone:913-588-9600
Mailing Address - Fax:
Practice Address - Street 1:4000 CAMBRIDGE STREET
Practice Address - Street 2:SUITE G600
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8501
Practice Address - Country:US
Practice Address - Phone:913-588-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-30379207RC0000X, 207RC0001X
MO116185207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO33428016OtherBCBS KC
KS200003890BMedicaid
KS200003890AMedicaid
MO209268705Medicaid
KS103448OtherBCBS KS
MO038E00020Medicare PIN
KS103448OtherBCBS KS
KS200003890BMedicaid
MOP00162384Medicare PIN
MO33428016OtherBCBS KC
KS103448Medicare PIN
I00115Medicare UPIN
KSP00098337Medicare PIN