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LEE'S SUMMIT DERMATOLOGY ASSOCIATES I, PC
NPI 1205972270
Specialist in Lee's Summit, MO

Active since January 29, 2007CLIA 26D0975973 · Certificate of Compliance
276 NE TUDOR RD, LEE'S SUMMIT, MO 64086(816) 525-8500(816) 525-0185 Get Directions Write a Review

NPPES record last updated: August 22, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Lee's Summit Dermatology Associates I, Pc NPPES

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

LEE'S SUMMIT DERMATOLOGY ASSOCIATES I, PC (NPI 1205972270) is a healthcare organization registered as a specialist in Lee's Summit, Missouri and active in the NPI registry since January 2007. The organization holds a CLIA Certificate of Compliance certificate valid through December 7, 2026 and lists Gary W Mcewen, Owner, as its authorized official.

NPPES Registry Identity

NPI1205972270
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameLEE'S SUMMIT DERMATOLOGY ASSOCIATES I, PC
Location Address276 NE TUDOR RDLee's Summit, MO 64086-5696
Mailing Address276 Ne Tudor RdLee's Summit, MO 64086-5696 · (816) 525-8500 · Fax (816) 525-0185
Phone(816) 525-8500
Fax(816) 525-0185
Organization SubpartNo
Authorized OfficialGary W McewenOwner · (816) 525-8500
Enumeration DateJanuary 29, 2007
Last NPPES UpdateAugust 22, 2008
✔ NPI 1205972270 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in MO · R9N60
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
276 NE TUDOR RD, Lee's Summit, MO 64086
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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lee's Summit Dermatology Associates I, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Lee's Summit Dermatology Associates I, PC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Matthew Mcewen, MD
Dermatology
NPI 1730686643
276 NE TUDOR RD
Lees Summit, MO 64086
(816) 525-8500
✔ PECOS✔ Accepts MedicareSame address
Amber Kunshek, NP
Nurse Practitioner
NPI 1861508871
276 NE TUDOR RD
Lees Summit, MO 64086
(816) 525-8500
✔ PECOS✔ Accepts MedicareSame address
Gary Mcewen, M.D.
Dermatology
NPI 1477554657
276 NE TUDOR RD
Lee's Summit, MO 64086
(816) 525-8500
✔ 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.

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 Compliance 26D0975973

Lees Summit Dermatology · Lees Summit, MO
Active · expires Dec 7, 2026
CLIA Number26D0975973
Laboratory TypePhysician Office
Certificate Effective DateDecember 8, 2024
Certificate Expiration DateDecember 7, 2026
Laboratory DirectorGary W. Mcewen
Laboratory Phone(816) 525-8500
Laboratory LocationLees Summit Dermatology276 NE Tudor Rd, Lees Summit, MO 64086
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Lee's Summit Dermatology Associates I, PC's NPI number?

The NPI number for Lee's Summit Dermatology Associates I, PC is 1205972270. It was assigned to this organization in the NPPES registry on January 29, 2007.

Where is Lee's Summit Dermatology Associates I, PC located?

Lee's Summit Dermatology Associates I, PC is located at 276 NE Tudor Rd, Lee's Summit, MO 64086. The listed phone number is (816) 525-8500.

What is Lee's Summit Dermatology Associates I, PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Lee's Summit Dermatology Associates I, PC enrolled in Medicare?

Yes. Lee's Summit Dermatology Associates I, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lee's Summit Dermatology Associates I, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Lee's Summit Dermatology Associates I, PC, in Dermatology and Nurse Practitioner. 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. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Lee's Summit Dermatology Associates I, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 26D0975973) is associated with this NPI, valid through December 7, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lee's Summit Dermatology Associates I, PC accept?

Health plans from Anthem Blue Cross and Blue Shield list Lee's Summit Dermatology Associates I, PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lee's Summit Dermatology Associates I, PC was last updated on August 22, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.