NPIMap

Individual provider Active NPI

Benjamin Ray Kimball, PA

  • Physician Assistant
  • Wichita, KS
National Provider Identifier
1114409893
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15-02118 Issued in KS
Practice address
550 N Hillside St
Wichita, KS 67214-4910
Phone
(316) 962-2000
NPI assigned
Aug 30, 2018
Last updated
Sep 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15-02118 KS Primary

Addresses

Primary practice location

550 N Hillside St
Wichita, KS 67214-4910

Mailing address

550 N Hillside St
Wichita, KS 67214-4910
Phone (316) 962-2000

Other practice location 1

750 W D Ave
Kingman, KS 67068-1266
Phone (620) 532-3147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181009000777 KS Practitioner - Physician Assistant 4183976822 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intensive Care Consortium - Midwest, LLCGroup PAC ID 2163893348, 27 clinicians

Practice addresses (Care Compare)

550 N Hillside St
Wichita, KS 67214-4910
Phone (615) 981-0839

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15-02118KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Inc CurrentSince Sep 20, 2021 Accepting new patients
Ninnescah Valley Health Systems, Inc. Current Accepting new patients
Ninnescah Valley Health Systems, Inc. CurrentSince Mar 10, 2024 Accepting new patients
Decatur Health Systems Inc Current Accepting new patients
Graham County Hospital CurrentSince Sep 1, 2018 Accepting new patients
Hillsboro Hospital LLC Current Accepting new patients
Graham County Hospital CurrentSince Sep 1, 2018 Accepting new patients
Cancer Center of Kansas, P.a. Past Accepting new patients

Locations

304 W Prout St
Hill City, KS 67642
Phone (785) 421-2121

101 Industrial Rd
Hillsboro, KS 67063
Phone (620) 877-4165

750 W D Ave
Kingman, KS 67068
Phone (620) 532-0295

810 W Columbia St
Oberlin, KS 67749
Phone (785) 475-2200

902 W Columbia St
Oberlin, KS 67749
Phone (785) 475-2221

Interoperability endpoints

  • Direct secure messaging: benjamin.kimball@hca3.eclinicaldirectplus.com

Organizations & group practices 11

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1114409893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 N HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144910",
            "telephone_number": "316-962-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 N HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144910",
            "telephone_number": "316-962-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 W D Ave",
            "address_purpose": "LOCATION",
            "city": "Kingman",
            "state": "KS",
            "postal_code": "670681266",
            "country_code": "US",
            "telephone_number": "620-532-3147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "BENJAMIN",
        "middle_name": "RAY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-30",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-02118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.