Chamil Fernando

Individual provider Active NPI Medical Physician Assistant · Wichita, KS

NPI 1003776337 · NPPES record last updated Nov 18, 2025

Key facts

NPI
1003776337
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
15-03186 (KS)
Practice address
3417 S Meridian Ave
Wichita, KS 67217-2151
Phone
(316) 866-2078
NPI assigned
Nov 18, 2025
Sex
Male
Sole proprietor
No

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gracemed Health Clinic Inc (14 clinicians)

Practice addresses (Care Compare)

1122 N Topeka St
Wichita, KS 67214-2810
Phone (316) 866-2000

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20251229000191 KS Practitioner - Physician Assistant 5698261790 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15-03186KSMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gracemed Health Clinic Inc Current
since Feb 9, 2026
Accepting new patients
Gracemed Health Clinic, Inc Current
since Feb 9, 2026
Accepting new patients

Locations

1122 N Topeka St
Wichita, KS 67214
Phone (316) 263-7455

1150 N Broadway Ave
Wichita, KS 67214

3417 S Meridian Ave
Wichita, KS 67217
Phone (316) 866-2078

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 15-03186 KS Yes

Addresses

Primary practice location

3417 S Meridian Ave
Wichita, KS 67217-2151

Mailing address

1150 N Broadway Ave
Wichita, KS 67214-2805
Phone (316) 866-2075

Other practice location 1

1122 N Topeka St
Wichita, KS 67214-2810
Phone (316) 866-2000

Other providers in Wichita, KS

All providers in Wichita, KS · Medical Physician Assistant in Kansas

Sources for this page

Verify at the official NPI Registry.