WHITE OAK PSYCHIATRIC SERVICES
NPI 1376757617
Psychologist - Prescribing (Medical) in Lees Summit, MO

NPI Status: Active since May 09, 2007

Contact Information

4045 NE LAKEWOOD WAY
SUITE 130
LEES SUMMIT, MO
ZIP 64064
Phone: (816) 886-2184
Fax: (816) 886-2397

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  • Organization
  • Psychologist
  • Prescribing (Medical)
  • Accepts Insurance
  • CLIA Number: 26D2064678
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-22-2025

About WHITE OAK PSYCHIATRIC SERVICES

This page provides the complete NPI Profile along with additional information for White Oak Psychiatric Services, a provider established in Lees Summit, Missouri operating as a Psychologist, focusing in prescribing (medical) . The healthcare provider is registered in the NPI registry with number 1376757617 assigned on May 2007. The practitioner's primary taxonomy code is 103TP0016X with license number RICIO (MO). The provider is registered as an organization and their NPI record was last updated 11 years ago. White Oak Psychiatric Services operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as White Oak Psychiatric Services. The authorized official of this NPI record is Dr. Mohammed Azher Mirza M.d. (Owner)

NPI
1376757617
Provider Legal Name
M A MIRZA, LLC
Other Organization Name
WHITE OAK PSYCHIATRIC SERVICES
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
4045 NE LAKEWOOD WAY SUITE 130 LEES SUMMIT, MO 64064
Location Phone
(816) 886-2184
Location Fax
(816) 886-2397
Mailing Address
4045 NE LAKEWOOD WAY SUITE 130 LEES SUMMIT, MO 64064
Mailing Phone
(816) 886-2184
Mailing Fax
(816) 886-2397
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-09-2007
Last Update Date
03-21-2014
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Psychologist Prescribing (Medical)

Taxonomy Code
103TP0016X
Type
Behavioral Health & Social Service Providers
License No.
RICIO
License State
MO
Taxonomy Description
A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Bronze 2 Advanced HSA: Aetna network + CVS Health Virtual Primary Care - EPO
  • Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - EPO
  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - EPO
  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - EPO
  • Bronze 4 Advanced: Aetna network + $0 CVS Health Virtual Primary Care - EPO
  • Bronze 4 Advanced: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental + Vision - EPO
  • Bronze S: Aetna network + $0 CVS Health Virtual Primary Care - EPO
  • Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - EPO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - EPO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - EPO
  • Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - EPO
  • Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision - EPO
  • Gold S: Aetna network + $0 CVS Health Virtual Primary Care - EPO
  • Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - EPO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - EPO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - EPO
  • Silver 10 Advanced: Aetna network + $0 CVS Health Virtual Primary Care - EPO
  • Silver 10 Advanced: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental + Vision - EPO
  • Silver 5 Advanced: Aetna network + $0 CVS Health Virtual Primary Care - EPO
  • Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - EPO
  • Choice Bronze HSA (QualChoice) - POS
  • Complete Gold - PPO
  • Complete Gold + Vision + Adult Dental - PPO
  • Complete Silver (QualChoice) - POS
  • Connected Silver - PPO
  • Connected Silver (QualChoice) - POS
  • Connected Silver (QualChoiceLife) - PPO
  • Connected Silver + Vision + Adult Dental - PPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold (QualChoice) - POS
  • Elite Gold (QualChoiceLife) - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Everyday Gold - PPO
  • Everyday Gold + Vision + Adult Dental - PPO
  • Everyday Silver (QualChoiceLife) - PPO
  • Focused Silver - PPO
  • Focused Silver + Vision + Adult Dental - PPO
  • Standard Expanded Bronze - PPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Premier Silver - EPO
  • Premier Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Gold - HMO
  • Clear Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Clear Silver - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Silver - HMO
  • Elite Silver + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Premier Bronze HSA - EPO
  • Premier Bronze HSA + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Central Bronze - HMO
  • Central Bronze + Vision + Adult Dental - HMO
  • Central Gold - HMO
  • Central Gold + Vision + Adult Dental - HMO
  • Clear Silver - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold - PPO
  • Elite Gold + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Everyday Gold - PPO
  • Everyday Gold + Vision + Adult Dental - PPO
  • Focused Silver - PPO
  • Focused Silver + Vision + Adult Dental - PPO
  • Standard Expanded Bronze - PPO
  • Standard Expanded Bronze + Vision + Adult Dental - PPO
  • Standard Gold - PPO
  • Standard Gold + Vision + Adult Dental - PPO
  • Standard Silver - PPO
  • Clear Silver - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Bronze Pathway 9200 (+ Incentives) - EPO
  • Anthem Catastrophic Pathway 9200 (+ Incentives) - EPO
  • Anthem Gold Pathway 1500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Heart Healthy Bronze Pathway 4900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Heart Healthy Silver Pathway 2900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Silver Pathway 5000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Silver Pathway 5350 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Silver Pathway 7250 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Balance by Medica Bronze $0 Copay PCP Visits - EPO
  • Balance by Medica Bronze Premier - EPO
  • Balance by Medica Catastrophic - EPO
  • Balance by Medica Expanded Bronze Standard - EPO
  • Balance by Medica Gold $0 Copay PCP Visits - EPO
  • Balance by Medica Gold Share - EPO
  • Balance by Medica Gold Standard - EPO
  • Balance by Medica Silver $0 Copay PCP Visits - EPO
  • Balance by Medica Silver Share - EPO
  • Balance by Medica Silver Standard - EPO
  • Medica with MU Health Care Bronze $0 Copay PCP Visits - EPO
  • Medica with MU Health Care Bronze Premier - EPO
  • Medica with MU Health Care Catastrophic - EPO
  • Medica with MU Health Care Expanded Bronze Standard - EPO
  • Medica with MU Health Care Gold $0 Copay PCP Visits - EPO
  • Medica with MU Health Care Gold Share - EPO
  • Medica with MU Health Care Gold Standard - EPO
  • Medica with MU Health Care Silver $0 Copay PCP Visits - EPO
  • Medica with MU Health Care Silver Share - EPO
  • Medica with MU Health Care Silver Standard - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. MOHAMMED AZHER MIRZA M.D.

Authorized Official Title
OWNER
Authorized Official Phone
(816) 228-5335

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
26D2064678
Facility Type
Physician Office
Certificate Effective Date
August 23, 2023
Certificate Expiration Date
August 22, 2025
Laboratory Director
MOHAMMED A. MIRZA
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to White Oak Psychiatric Services to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for WHITE OAK PSYCHIATRIC SERVICES

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1376757617
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
231461451462
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 1 + 4 + 6 + 1 + 4 + 5 + 1 + 4 + 6 + 2 + 24 = 63
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 63 = 77

The NPI number 1376757617 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1134235112DR. BRUCE EUGENE ROSENBAUM D.D.S.
Individual
Dentist (General Practice)4045 NE LAKEWOOD WAY SUITE 150
LEES SUMMIT, MO 64064
(816) 350-9119
1336355585 SHUBHA RAJA M.B.B.S.
Individual
Psychiatry & Neurology (Child & Adolescent Psychiatry)4045 NE LAKEWOOD WAY SUITE 130
LEES SUMMIT, MO 64064
(816) 886-2184
1396723706 CASEY S PROUGH MD
Individual
Psychiatry & Neurology (Psychiatry)4045 NE LAKEWOOD WAY SUITE 130
LEES SUMMIT, MO 64064
(816) 886-2184
1871525162DR. MARGUERITE DEVONNE FRENCH M.D.
Individual
Psychiatry & Neurology (Psychiatry)4045 NE LAKEWOOD WAY SUITE 130
LEES SUMMIT, MO 64064
(816) 886-2184
1710067822 MOHAMMED AZHER MIRZA MD
Individual
Psychiatry & Neurology (Psychiatry)4045 NE LAKEWOOD WAY STE 130
LEES SUMMIT, MO 64064
(816) 228-5335

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1376757617, enumerated in the NPI registry as an "organization" on May 09, 2007

The provider is located at 4045 Ne Lakewood Way Suite 130 Lees Summit, Mo 64064 and the phone number is (816) 886-2184

This medical organization specializes in Psychologist with taxonomy code 103TP0016X with a focus in Prescribing (Medical)

The provider might be accepting Accepts: Aetna CVS Health, Ambetter from Arkansas Health &. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider's CLIA number is 26D2064678 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on May 09, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.