CENTERWELL SENIOR PRIMARY CARE- STATE AVENUE
NPI 1104347756
Internal Medicine in Kansas City, KS
About Centerwell Senior Primary Care- State Avenue NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CENTERWELL SENIOR PRIMARY CARE- STATE AVENUE (NPI 1104347756) is a healthcare organization registered as an internal medicine in Kansas City, Kansas and active in the NPI registry since July 2017. The organization holds a CLIA Waiver certificate valid through September 13, 2027 and lists Angie Martinez, Senior Credentialing Professional, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 4
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Centerwell Senior Primary Care- State Avenue is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
41Medicare enrollment records show 41 clinicians reassign Medicare billing to Centerwell Senior Primary Care- State Avenue, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 7 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 5
Nearest to this location (20)
See all 41Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 17D2136731
Centerwell Senior Primary Care-State Avenue · Kansas City, KSFrequently 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 Centerwell Senior Primary Care Ks PA's NPI number?
The NPI number for Centerwell Senior Primary Care Ks PA is 1104347756. It was assigned to this organization in the NPPES registry on July 5, 2017. The provider is doing business as Centerwell Senior Primary Care- State Avenue and Partners in Primary Care- State Avenue. The provider was formerly known as Partners in Primary Care TX PA and Partners inPrimary Care (KS), P.A..
Where is Centerwell Senior Primary Care Ks PA located?
Centerwell Senior Primary Care Ks PA is located at 7527 State Ave, Kansas City, KS 66112. The listed phone number is (913) 335-6986.
What is Centerwell Senior Primary Care Ks PA's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Centerwell Senior Primary Care Ks PA enrolled in Medicare?
Yes. Centerwell Senior Primary Care Ks PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Centerwell Senior Primary Care Ks PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 41 clinicians in 5 Medicare specialties reassign their Medicare billing to Centerwell Senior Primary Care Ks PA. 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. The largest specialties are Nurse Practitioner (16), Cardiovascular Disease (Cardiology) (9) and Internal Medicine (9). Of these, 3 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Centerwell Senior Primary Care Ks PA hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 17D2136731) is associated with this NPI, valid through September 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Centerwell Senior Primary Care Ks PA was last updated on August 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Centerwell Senior Primary Care- State Avenue · NPI 1104347756
Internal Medicine organization in Kansas City, Kansas. Organization record, active in the CMS NPPES registry since July 5, 2017.
## Identity
- **NPI:** 1104347756 (Entity type: Organization)
- **Enumerated:** July 5, 2017
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Legal business name:** Centerwell Senior Primary Care Ks Pa
- **Also known as:** Partners in Primary Care- State Avenue (Doing Business As); Partners in Primary Care TX PA (Former Legal Business Name); Partners inPrimary Care (KS), P.A. (Former Legal Business Name)
- **Organization subpart:** Yes (part of Centerwell Senior Primary Care Ks Pa)
- **Authorized official:** Angie Martinez, SENIOR CREDENTIALING PROFESSIONAL
## Practice location
- **Address:** 7527 STATE AVE, Kansas City, KS 66112-2815
- **Phone:** (913) 335-6986 · **Fax:** (855) 446-7151
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 41 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (16), Cardiovascular Disease (Cardiology) (9), Internal Medicine (9); 3 practice at this address and 7 within 10 miles; [full list](https://npiprofile.com/npi/1104347756/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 19, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1104347756) · Data from the CMS NPPES public registry.