Individual provider Active NPI

Chamil Fernando

  • Medical Physician Assistant
  • Wichita, KS
National Provider Identifier
1003776337
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
15-03186 Issued in KS
Practice address
3417 S Meridian Ave
Wichita, KS 67217-2151
Phone
(316) 866-2078
NPI assigned
Nov 18, 2025
Last updated
Nov 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

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

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

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

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gracemed Health Clinic IncGroup PAC ID 9830098185, 14 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15-03186KSMDMedical Physician Assistant

Practice roles

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

Organizations & group practices 2

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1763424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1003776337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N BROADWAY AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672142805",
            "telephone_number": "316-866-2075",
            "fax_number": "316-252-8784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 S MERIDIAN AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672172151",
            "telephone_number": "316-866-2078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1122 N Topeka St",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672142810",
            "country_code": "US",
            "telephone_number": "316-866-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDO",
        "first_name": "CHAMIL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-18",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KS",
            "license": "15-03186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.