Provider Demographics
NPI:1750331617
Name:SCHNEIDER, ALAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:M
Last Name:SCHNEIDER
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 1:5701 W 119TH ST
Mailing Address - Street 2:SUITE 430
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-3721
Mailing Address - Country:US
Mailing Address - Phone:913-253-3000
Mailing Address - Fax:913-663-2980
Practice Address - Street 1:5701 W 119TH ST
Practice Address - Street 2:SUITE 430
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-3721
Practice Address - Country:US
Practice Address - Phone:913-253-3000
Practice Address - Fax:913-663-2980
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO111447207RC0000X
KS0426454207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100192330AMedicaid
MOP00770544OtherMO RAILROAD MEDICARE
KSP00716894OtherKS-RAILROAD PTAN
MO208498014Medicaid
KS100192330AMedicaid
KSK679514AMedicare UPIN
KSP00716894OtherKS-RAILROAD PTAN
KSKA1701011Medicare PIN
MOMA2310011Medicare PIN
KSG43875Medicare UPIN
MOK679514Medicare PIN
MO4509514AMedicare ID - Type UnspecifiedMO MEDICARE #