Provider Demographics
NPI:1689678096
Name:CASTERA, PIERRE (MD)
Entity Type:Individual
Prefix:
First Name:PIERRE
Middle Name:
Last Name:CASTERA
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 1:6060 N OAK TRFY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GLADSTONE
Mailing Address - State:MO
Mailing Address - Zip Code:64118-5130
Mailing Address - Country:US
Mailing Address - Phone:816-941-0800
Mailing Address - Fax:816-941-0080
Practice Address - Street 1:4370 W 109TH ST
Practice Address - Street 2:SUITE 350
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1361
Practice Address - Country:US
Practice Address - Phone:816-941-0800
Practice Address - Fax:816-941-0080
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0430049208C00000X
MO104225208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207931205Medicaid
KS100185760BMedicaid
MO207931205Medicaid
KS100185760BMedicaid
MOA925615Medicare PIN
KSKA1885002Medicare PIN