CHRISTIE MICHELLE BROCK (D.O.) – Surgery Physician, NPI 1417195140

CHRISTIE MICHELLE BROCK (D.O.) is a healthcare provider. based in Lees summit, Missouri. specializing in GENERAL SURGERY. They hold the professional credentials D.O.. They hold a License No. 2012017084 (MO). The NPI Number for CHRISTIE MICHELLE BROCK (D.O.) is 1417195140

Main info

Female
19 Years Of Experience
Accepts Medicare Assignment
Name
CHRISTIE MICHELLE BROCK (D.O.)
NPI
1417195140
Phone
(816) 246-0800
Address
3460 NE RALPH POWELL RD
Enumeration Date
3 February 2009
Last Update Date
2 July 2013

Doctor Profile

Medical School Name
KANSAS CITY UNIVERSITY OF MED & BIOSCIENCES, COLLEGE OF OSTEO MED
Secondary Phone
9135413540
Graduation Year
2007 (19 years ago)
PAC ID
0244483022
Group Practice PAC ID
9032272026
Professional Enrollment ID
I20240320002659
Address ID
KS662152303OV10550RDXX302
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

785 GENERAL SURGERY in MO

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Provider Addresses for CHRISTIE MICHELLE BROCK (D.O.)

  • 3460, Northeast Ralph Powell Road, Chapel Ridge Business Park, Lee's Summit, Jackson County, Missouri, 64064, United States

    LEES SUMMIT, MO 640642361

    Phone: (816) 246-0800

    Fax: (816) 246-6613

    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: 2024-03-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20130102000413ICritical Care (Intensivists)MOTBD
I20240320002659IGeneral SurgeryKSTBD

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 64064)

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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: 9032272026View full group profile
NameSpecialtyState
Nurse PractitionerMO
-KS
Nurse PractitionerKS
-KS
N E U R O S U R G E R YIL
General SurgeryIL
General Surgery, Critical Care (Intensivists)KS
Nurse PractitionerKS
N E U R O S U R G E R YOR
Nurse PractitionerKS

Reviews

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Frequently asked questions

Can I verify CHRISTIE MICHELLE BROCK (D.O.) with an NPI only?
You can start verification with NPI 1417195140 for CHRISTIE MICHELLE BROCK (D.O.), then check state licensing separately.
Can I rely on CHRISTIE MICHELLE BROCK (D.O.) being an active provider?
As of the registry snapshot, CHRISTIE MICHELLE BROCK (D.O.) is marked active.
What is CHRISTIE MICHELLE BROCK (D.O.)'s primary classification?
Surgery Physician is the headline specialty for CHRISTIE MICHELLE BROCK (D.O.) here. Clinical services aligned with this taxonomy classification.
What address line appears for CHRISTIE MICHELLE BROCK (D.O.)?
CHRISTIE MICHELLE BROCK (D.O.)'s geographic hint is Lees Summit, Missouri in our summary view.
Why does CHRISTIE MICHELLE BROCK (D.O.) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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