DR. LUKE GILDO MIRABELLI MD NPI 1710447255

NPI Information

NPI: 1710447255
Provider Name: DR. LUKE GILDO MIRABELLI, MD
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual

PECOS Registration: Yes

Address:
3901 RAINBOW BLVD # MS 1060
KANSAS CITY, KS
ZIP 66160
Phone: (913) 588-5276
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DR. Luke Gildo Mirabelli, MD is a student in an organized health care education training program in Kansas City, KS. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. DR. Luke Gildo Mirabelli, MD NPI is 1710447255. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3901 RAINBOW BLVD # MS 1060
KANSAS CITY, KS
ZIP 66160-500
Phone: (913) 588-5276
Fax: (913) 588-3974

The NPI 1710447255 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/21/2019 and was last updated on 7/6/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084P0800X	Psychiatry & Neurology	Psychiatry	2023025341	MISSOURI	No
2	2084P0800X	Psychiatry & Neurology	Psychiatry	94-09805	KANSAS	No
3	390200000X	Student in an Organized Health Care Education/Training Program				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	94-09805	OTHER	KANSAS	KANSAS STATE BOARD OF HEALING ARTS
2	2023025341	OTHER	MISSOURI	MISSOURI STATE BOARD OF REGISTRATION FOR THE HEALING ARTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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