CLAY PLATTE FAMILY MEDICINE CLINIC – Family Medicine Physician, NPI 1073570487
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for CLAY PLATTE FAMILY MEDICINE CLINIC
5501 NW 62ND TER STE 100
KANSAS CITY, MO 641512412
Phone: (816) 842-4440
Fax: (816) 842-1974
Type: Mailing
5501, Northwest 62nd Terrace, Tremont Square, Kansas City, Platte County, Missouri, 64151, United States
SUITE 100
KANSAS CITY, MO 641512411
Phone: (816) 842-4440
Fax: (816) 842-1974
Type: Mailing
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: 2010-09-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-06-30 (713 days ago).
Enrollment records
2
Earliest due date
2024-06-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040120000899 | O | Clinic/Group Practice | MO | TBD |
| O20100930029257 | O | Physician - Family Practice | MO | 2024-06-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 64151)
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