Provider Demographics
NPI:1467406306
Name:MID-AMERICA CARDIOLOGY ASSOCIATES, INC.
Entity Type:Organization
Organization Name:MID-AMERICA CARDIOLOGY ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PRACTICE EXECUTIVE
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RASMUSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-588-9600
Mailing Address - Street 1:2330 SHAWNEE MISSION PKWY STE 312
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2005
Mailing Address - Country:US
Mailing Address - Phone:913-588-9600
Mailing Address - Fax:
Practice Address - Street 1:3901 RAINBOW BLVD STE G600
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160
Practice Address - Country:US
Practice Address - Phone:913-588-9600
Practice Address - Fax:913-588-9770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant CardiologyGroup - Single Specialty
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100213330AMedicaid
KS100213330BMedicaid
MO00469013OtherBCBS KC
KS110330OtherBCBS OF KS
KS110330Medicare PIN
MO0380000EMedicare PIN
KS0380000BMedicare PIN
KS100213330BMedicaid
KSCH3545Medicare PIN
MO0380000AMedicare PIN
MOCI2822Medicare PIN
MO0380000EMedicare PIN
KS0380000BMedicare PIN
KS100213330BMedicaid
KSCH3545Medicare PIN
MO0380000AMedicare PIN