JON ROBERT HUMISTON (PA) – Physician Assistant, NPI 1174779250

JON ROBERT HUMISTON (PA) is a healthcare provider. based in Kansas city, Missouri. specializing in Physician Assistant. They hold the professional credentials PA. They hold a License No. 2018002356 (MO). The NPI Number for JON ROBERT HUMISTON (PA) is 1174779250

Main info

Male
18 Years Of Experience
Accepts Medicare Assignment
Name
JON ROBERT HUMISTON (PA)
NPI
1174779250
Phone
(816) 276-7410
Address
6675 HOLMES RD STE 400&425
Enumeration Date
8 August 2008
Last Update Date
31 January 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9135415000
Graduation Year
2008 (18 years ago)
PAC ID
1557439023
Group Practice PAC ID
5092733402
Professional Enrollment ID
I20081010000242

Contacts

Secure Messaging
JON.HUMISTON@hca2.eclinicaldirectplus.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness85
Years active:17State licenses:1Other namesUpdated within 12 months

Provider Addresses for JON ROBERT HUMISTON (PA)

  • 6675 HOLMES RD STE 400&425

    KANSAS CITY, MO 641311150

    Phone: (816) 276-7410

    Fax: (816) 276-7450

    Mailing address matches the actual address.

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: 2008-10-10

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
I20081010000242IPhysician AssistantKSTBD

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 64131)

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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: 5092733402View full group profile

Reviews

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Frequently asked questions

How is JON ROBERT HUMISTON (PA) identified in CMS data?
CMS-hosted NPPES data lists JON ROBERT HUMISTON (PA) with NPI 1174779250.
Is JON ROBERT HUMISTON (PA) still practicing?
JON ROBERT HUMISTON (PA) is currently listed as active in the public NPI registry.
What taxonomy line describes JON ROBERT HUMISTON (PA)?
For research purposes, treat JON ROBERT HUMISTON (PA) as Physician Assistant in this dataset. Clinical services aligned with this taxonomy classification.
Where is JON ROBERT HUMISTON (PA) based?
JON ROBERT HUMISTON (PA) is tied to Kansas City, Missouri in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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