Micca Schneider, MD
Individual provider Active NPI Family Medicine Physician · Great Bend, KS
NPI 1013400431 · NPPES record last updated Jul 28, 2022
Key facts
- NPI
- 1013400431
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 94-09529 (KS)
- Practice address
- 3515 Broadway Ave
Great Bend, KS 67530-3633 - Phone
- (620) 792-2511
- Fax
- (620) 860-0619
- NPI assigned
- Jun 11, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 15
Owned or controlled facilities with NPI records 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Kansas School of Med (KC/Wich/Sal), 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ukhs Great Bend LLC
Practice addresses (Care Compare)
3515 Broadway Ave
Great Bend, KS 67530-3633
Phone (620) 786-6515
Hospital & facility affiliations
- Angels Care Home Health of Dodge City
- Gentiva
- University of KS HLTH System Great Bend Campus
- Clara Barton Hospital
- Ellinwood District Hospital
- Pawnee Valley Community Hospital
- University of Kansas Hospital
- Wheatland Nursing & Rehabilitation Center
- Azria Health Great Bend
- Medicalodges Great Bend
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: Yes
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Golden Belt Home Health |
Home health agency | W-2 Managing Employee | Jun 1, 2025 |
| Golden Belt Hospice |
Hospice | W-2 Managing Employee | Jun 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210903000195 | KS | Practitioner - Family Practice | 4082963491 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 94-09529 | KS | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ukhs Great Bend, LLC | Family Medicine | Current |
Accepting new patients |
| Ukhs Great Bend, LLC | Past | Accepting new patients | |
| Ukhs Great Bend, LLC | Past | Accepting new patients |
Locations
514 Cleveland St
Great Bend, KS 67530
Phone (620) 659-2890
3515 Broadway Ave
Great Bend, KS 67530
Phone (620) 786-6163
Interoperability endpoints
- mschneider546826@direct.kuha.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 94-09529 | KS | Yes |
Addresses
Primary practice location
3515 Broadway Ave
Great Bend, KS 67530-3633
Mailing address
3515 Broadway Ave
Great Bend, KS 67530-3633
Phone (620) 792-2511
Other practice location 1
514 Cleveland St
Great Bend, KS 67530-3562
Phone (620) 792-8833
Other providers in Great Bend, KS
- Sarah Schenek
- Yvonne R Scheufler
- Susan A Schilling
- Evan Myles Schneider
- Geralyn Marie Schneider
- Scott Schneider
- Shari Schneider
- Alesia Lee Schneweis
- Bridgett J Schneweis
- Caren S Schnittker
All providers in Great Bend, KS · Family Medicine Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.