Provider Demographics
NPI:1073510962
Name:BATLLE, IVAN R (MD)
Entity Type:Individual
Prefix:DR
First Name:IVAN
Middle Name:R
Last Name:BATLLE
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 1:8600 QUIVIRA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2857
Mailing Address - Country:US
Mailing Address - Phone:913-831-7400
Mailing Address - Fax:913-831-7409
Practice Address - Street 1:8600 QUIVIRA RD STE 100
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-2857
Practice Address - Country:US
Practice Address - Phone:913-831-7400
Practice Address - Fax:913-831-7409
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS16323207W00000X, 207WX0107X
MO2005041174207W00000X, 207WX0107X
TXM9839207W00000X, 207WX0107X
LAMD.08085R207W00000X, 207WX0107X
KS0431680207WX0107X
KS04-31680207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200602400AMedicaid
MO204182109Medicaid
KSP00277803OtherRAILROAD MEDICARE PIN
MOP00297991OtherRAILROAD MEDICARE PIN
KSP00297988OtherRAILROAD MEDICARE PIN
E10478Medicare UPIN
KS105319Medicare PIN