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

Nicole Petrillo, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1336728278

Nicole Petrillo, MD is an Obstetrics/Gynecology in Shawnee Mission, Kansas. Qualified in 2021, 5 years ago. Practices with Midwest Physician Services LLC, a 39-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Kansas.

Years since qualifying
5
Licensed in
KS
In the registry since
2021
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

7440 W Frontage Rd
Shawnee Mission, KS 66203-4670
Phone: (913) 236-6455
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3500 Gaston Ave, Dallas, TX 75246-2017 — (236) 121-4820

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 04-50947 (KS)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1336728278
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 7, 2021
Last updated in NPPESJune 17, 2025
Certification dateJune 17, 2025
Mailing address10906 W 169th Ter, Overland Park, KS 66221-7954

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Midwest Physician Services Llc — 39 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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