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IMPACT ORTHOPEDICS & SPORTS MEDICINE, LLC
NPI 1023697406
Orthopaedic Surgery in Prairie Village, KS

Active since April 05, 2021
5200 W 94TH TER STE 113, PRAIRIE VILLAGE, KS 66207(913) 906-8640(913) 906-8682 Get Directions Write a Review

NPPES record last updated: December 24, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 24, 2021, Jul 24, 2021, Apr 5, 2021 (3 updates tracked since 2021).

About Impact Orthopedics & Sports Medicine, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IMPACT ORTHOPEDICS & SPORTS MEDICINE, LLC (NPI 1023697406) is a healthcare organization registered as an orthopaedic surgery in Prairie Village, Kansas and active in the NPI registry since April 2021. The organization lists Michael Gabriel Azzam, Owner, as its authorized official.

NPPES Registry Identity

NPI1023697406
Entity TypeOrganization
Primary Taxonomy207X00000X
Legal Business NameIMPACT ORTHOPEDICS & SPORTS MEDICINE, LLC
Location Address5200 W 94TH TER STE 113Prairie Village, KS 66207-2522
Mailing Address5200 W 94th Ter Ste 113Prairie Village, KS 66207-2522 · (913) 906-8640 · Fax (913) 906-8682
Phone(913) 906-8640
Fax(913) 906-8682
Organization SubpartNo
Authorized OfficialMichael Gabriel AzzamOwner · (913) 906-8640
Enumeration DateApril 5, 2021
Last NPPES UpdateDecember 24, 20213 updates tracked since enumeration
NPPES CertifiedDecember 24, 2021
✔ NPI 1023697406 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
5200 W 94TH TER STE 113, Prairie Village, KS 66207
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Impact Orthopedics & Sports Medicine, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Impact Orthopedics & Sports Medicine, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Michael Azzam, M.D.
Orthopedic Surgery
NPI 1215258736
5200 W 94TH TER STE 113
Prairie Village, KS 66207
(913) 906-8640
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Impact Orthopedics & Sports Medicine, LLC's NPI number?

The NPI number for Impact Orthopedics & Sports Medicine, LLC is 1023697406. It was assigned to this organization in the NPPES registry on April 5, 2021.

Where is Impact Orthopedics & Sports Medicine, LLC located?

Impact Orthopedics & Sports Medicine, LLC is located at 5200 W 94th Ter Ste 113, Prairie Village, KS 66207. The listed phone number is (913) 906-8640.

What is Impact Orthopedics & Sports Medicine, LLC's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Impact Orthopedics & Sports Medicine, LLC enrolled in Medicare?

Yes. Impact Orthopedics & Sports Medicine, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Impact Orthopedics & Sports Medicine, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Orthopedic Surgery) reassigns their Medicare billing to Impact Orthopedics & Sports Medicine, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Impact Orthopedics & Sports Medicine, LLC was last updated on December 24, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.