Provider Demographics
NPI:1689685471
Name:HEGDE, SHRIPAD ROY (MD)
Entity Type:Individual
Prefix:
First Name:SHRIPAD
Middle Name:ROY
Last Name:HEGDE
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 1:4000 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 1:10787 NALL AVE STE 300
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1372
Practice Address - Country:US
Practice Address - Phone:913-588-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR1B81207RC0000X
KS04-19080207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100407050AMedicaid
KS4533765OtherAETNA /ALL CLINICS
MO202514212Medicaid
KS100407050BMedicaid
MO09061031OtherBCBS KC
KS101471OtherBCBS KS/ KS OUTREACH CLIN
KS4533765OtherAETNA /ALL CLINICS
KS0384777BMedicare PIN
MO0384777EMedicare PIN
MO09061031OtherBCBS KC
KS101471OtherBCBS KS/ KS OUTREACH CLIN
KS101471Medicare PIN
KS060067029Medicare PIN
KS4533765OtherAETNA /ALL CLINICS
MO038E00009Medicare PIN