Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Colorectal Surgery PA

Organization Colon & Rectal Surgery Physician · NPI 1053480897

Colorectal Surgery PA is a Colon & Rectal Surgery Physician in Shawnee Mission, Kansas. Licensed in Kansas and Missouri. Registered with an NPI since 2006.

Licensed in
KS, MO
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

8901 W 74th St #148
Shawnee Mission, KS 66204
Phone: (913) 831-1900
Fax: (913) 831-1999
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Colon & Rectal Surgery Physician (primary) Taxonomy 208C00000X · Licence 0424933 (KS)
Colon & Rectal Surgery Physician Taxonomy 208C00000X · Licence 105102 (MO)

Record details

NPI number1053480897
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official William Cirocco — Owner · (913) 831-1900
NPI enumeratedNovember 7, 2006
Last updated in NPPESAugust 22, 2020
Mailing address8901 W 74th St, 148, Shawnee Mission, KS 66204

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