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STATLAND MEDICAL GROUP LLC
NPI 1902123573
Internal Medicine in Overland Park, KS

Active since April 22, 2010CLIA 17D0887927 · Waiver
5701 W 119TH ST, SUITE 240, OVERLAND PARK, KS 66209(913) 345-8500(913) 647-3936 Get Directions Write a Review

NPPES record last updated: November 20, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Statland Medical Group Llc NPPES

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

STATLAND MEDICAL GROUP LLC (NPI 1902123573) is a healthcare organization registered as an internal medicine in Overland Park, Kansas and active in the NPI registry since April 2010. The organization holds a CLIA Waiver certificate valid through June 22, 2028 and lists Benjamin Calkins, Group Vice President, as its authorized official.

NPPES Registry Identity

NPI1902123573
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameSTATLAND MEDICAL GROUP LLC
Location Address5701 W 119TH ST, SUITE 240Overland Park, KS 66209-3721
Mailing Address2000 Health Park DrBrentwood, TN 37027-4692 · (615) 373-7406
Phone(913) 345-8500
Fax(913) 647-3936
Organization SubpartNo
Authorized OfficialBenjamin CalkinsGroup Vice President · (615) 372-6536
Enumeration DateApril 22, 2010
Last NPPES UpdateNovember 20, 2025
NPPES CertifiedNovember 20, 2025
✔ NPI 1902123573 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedInternal Medicine · Endocrinology, Diabetes & MetabolismTaxonomy 207RE0101X
5701 W 119TH ST, Overland Park, KS 66209
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Sunflower Health Plan, Ambetter Health, Ambetter Health of Delaware and more.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)

Statland Medical Group Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Statland Medical Group LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (5)

Michael Sokol, MD
Internal Medicine
NPI 1235163676
5701 W 119TH ST SUITE 240
Overland Park, KS 66209
(913) 345-8500
✔ PECOS✔ Accepts MedicareSame address
Christopher Pelton, FNP-C
Nurse Practitioner
NPI 1184016529
506 NW MURRAY RD
Lees Summit, MO 64081
(816) 525-4400
✔ PECOS✔ Accepts Medicare13 mi
Pandurang Chillal, M.D.
Internal Medicine
NPI 1407968753
20 NE SAINT LUKES BLVD SUITE 350
Lees Summit, MO 64086
(816) 943-0706
✔ PECOS✔ Accepts Medicare15 mi
Nidal Boutros
Internal Medicine
NPI 1629036173
120 HOSPITAL DR SUITE 300
Lebanon, MO 65536
(417) 533-6746
✔ PECOS✔ Accepts Medicare139 mi
Garrett Wilt, DO
Internal Medicine
NPI 1518535913
1111 6TH AVE
Des Moines, IA 50314
(515) 643-2261
✔ PECOS✔ Accepts Medicare193 mi

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 Waiver 17D0887927

Statland Medical Group · Overland Park, KS
Active · expires Jun 22, 2028
CLIA Number17D0887927
Laboratory TypePhysician Office
Certificate Effective DateJune 23, 2026
Certificate Expiration DateJune 22, 2028
Laboratory DirectorMichael S. Sokol
Laboratory Phone(913) 345-8500
Laboratory LocationStatland Medical Group5701 West 119th Street, Suite 330, Lab Room #2, Overland Park, KS 66209
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Statland Medical Group LLC's NPI number?

The NPI number for Statland Medical Group LLC is 1902123573. It was assigned to this organization in the NPPES registry on April 22, 2010.

Where is Statland Medical Group LLC located?

Statland Medical Group LLC is located at 5701 W 119th St Suite 240, Overland Park, KS 66209. The listed phone number is (913) 345-8500.

What is Statland Medical Group LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Statland Medical Group LLC enrolled in Medicare?

Yes. Statland Medical Group LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Statland Medical Group LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Statland Medical Group 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. The largest specialties are Internal Medicine (4) and Nurse Practitioner (1). Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Statland Medical Group LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 17D0887927) is associated with this NPI, valid through June 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Statland Medical Group LLC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Sunflower Health Plan, Ambetter of Oklahoma and Anthem Blue Cross and Blue Shield list Statland Medical Group LLC 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 Statland Medical Group LLC was last updated on November 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.