DAXTEN PRUTER NURSE PRACTITIONER
NPI 1053866541
Nurse Practitioner - Family in Kansas City, MO

Q: What is Daxten Pruter's NPI number?

The NPI number for Daxten Pruter is 1053866541. It was assigned to this individual provider in the NPPES registry on August 24, 2016.

Q: What is Daxten Pruter's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Daxten Pruter was last updated on November 19, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 24, 2016PECOS Enrolled

4251 NORTHERN AVE, KANSAS CITY, MO 64133(181) 686-1470 Get Directions Write a Review

NPPES record last updated: November 19, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 19, 2020, Dec 18, 2019, Aug 24, 2016 (3 updates tracked since 2016).

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About Daxten Pruter Nurse Practitioner NPPES

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

DAXTEN PRUTER NURSE PRACTITIONER (NPI 1053866541) is an individual family provider in Kansas City, Missouri, licensed in Kansas (53-79163-032) and active in the NPI registry since August 2016. He is enrolled in Medicare PECOS and maintains a secondary practice location in Ponca City.

NPPES Registry Identity

NPI1053866541

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameDAXTEN PRUTERCredential: NURSE PRACTITIONER

Location Address4251 NORTHERN AVEKansas City, MO 64133-1593

Mailing Address4801 E Linwood BlvdKansas City, MO 64128-2226 · (816) 446-4082

Phone(181) 686-1470

Sole ProprietorNo

Enumeration DateAugust 24, 2016

Last NPPES UpdateNovember 19, 20203 updates tracked since enumeration

NPPES CertifiedNovember 19, 2020

✔ NPI 1053866541 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in KS · 53-79163-032

Also ListedRegistered NurseTaxonomy 163W00000X · License 0121556 (OK)

4251 NORTHERN AVE, Kansas City, MO 64133

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Secondary Practice Location 1

Location 113 Hillcrest DrPonca City, OK 74604-4808 · Phone (580) 762-3456 · Fax (580) 762-9600

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Daxten Pruter Nurse Practitioner is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 64133 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $55.29 – $168.52

Typical copayment $21.45 (range $13.82 – $42.13)

Most-billed visit code 99203

Established Patient

$97.82 typical visit price

range $17.60 – $137.20

Typical copayment $24.45 (range $4.40 – $34.30)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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