Provider Demographics
NPI:1114045358
Name:ANAST, JASON WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:WILLIAM
Last Name:ANAST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8551 BLUEJACKET ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66214-1656
Mailing Address - Country:US
Mailing Address - Phone:913-341-7985
Mailing Address - Fax:913-341-7988
Practice Address - Street 1:20375 W 151ST ST STE 409
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-7210
Practice Address - Country:US
Practice Address - Phone:913-780-3388
Practice Address - Fax:913-780-3256
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2012039473208800000X
KS04-38869208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS48913031OtherBCBS KC
KSJ71000031Medicare PIN
WA1114045358Medicaid