JUSTIN DASTRUP (DO) – Internal Medicine Physician, NPI 1023758083

JUSTIN DASTRUP (DO) is a healthcare provider. based in Liberty, Missouri. specializing in INTERNAL MEDICINE, HOSPITALIST. They hold the professional credentials DO. They hold a License No. 2025001426 (MO). The NPI Number for JUSTIN DASTRUP (DO) is 1023758083

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
JUSTIN DASTRUP (DO)
NPI
1023758083
Phone
(877) 840-6992
Address
2525 Glenn Hendren Dr
Enumeration Date
29 March 2022
Last Update Date
22 July 2025

Doctor Profile

Medical School Name
KANSAS CITY UNIVERSITY OF MED & BIOSCIENCES, COLLEGE OF OSTEO MED
Secondary Phone
8778406992
Graduation Year
2022 (4 years ago)
PAC ID
0648786186
Group Practice PAC ID
1759287527
Professional Enrollment ID
I20250722000470
Address ID
MO641163220NO2800XDRXX407
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness85
Years active:4State licenses:1Digital endpointsOther names

4,186 INTERNAL MEDICINE in MO

Provider Addresses for JUSTIN DASTRUP (DO)

  • 2525 Glenn Hendren Dr

    Liberty, MO 640689625

    Phone: (877) 840-6992

    Fax: (913) 495-3712

    Type: Location

  • 4502 E 41ST ST

    TULSA, OK 741352536

    Phone: (918) 660-3464

    Fax: (918) 660-3444

    Type: Mailing

  • 2750 CLAY EDWARDS DR STE 200A

    NORTH KANSAS CITY, MO 641163277

    Phone: (877) 840-6992

    Fax: (913) 495-3712

    Type: Mailing

  • 2800 CLAY EDWARDS DR

    NORTH KANSAS CITY, MO 641163220

    Phone: (877) 840-6992

    Fax: (913) 495-3712

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-07-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250722000470IInternal MedicineMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 64068)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1759287527View full group profile
NameSpecialtyState
H O S P I T A L I S TMO
-MO
H O S P I T A L I S TMO
Internal Medicine, HospitalistMO
Hospitalist, Internal MedicineMO
Hospitalist, Internal MedicineMO
Hospitalist, Internal MedicineMO
Hospitalist, Internal MedicineMO

Reviews

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Frequently asked questions

Does JUSTIN DASTRUP (DO) have a public NPI I can cite?
Public records show JUSTIN DASTRUP (DO) under NPI 1023758083.
Is JUSTIN DASTRUP (DO)'s NPI status active today?
Active status means JUSTIN DASTRUP (DO)'s NPI record is not deactivated in the public file.
How should patients interpret JUSTIN DASTRUP (DO)'s specialty?
The extract shows Internal Medicine Physician for JUSTIN DASTRUP (DO). Clinical services aligned with this taxonomy classification.
Which community is linked to JUSTIN DASTRUP (DO)?
JUSTIN DASTRUP (DO) shows a connection to Liberty, Missouri in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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