Individual provider Active NPI

Dane Michael Stark, PT

  • Physical Therapist
  • Wichita, KS
National Provider Identifier
1114904083
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1101792 Issued in KS
Practice address
1923 N Webb Rd
Wichita, KS 67206-3405
Phone
(316) 262-4886
Fax
(316) 262-4887
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1101792 KS Primary
Physical Therapist 225100000X 01968 MO

Addresses

Primary practice location

1923 N Webb Rd
Wichita, KS 67206-3405

Mailing address

1923 N Webb Rd
Wichita, KS 67206-3405
Phone (316) 262-4886

Other practice location 1

2348 W Central Ave Ste B
El Dorado, KS 67042-3465
Phone (316) 452-5033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090205000077 KS Practitioner - Physical Therapist in Private Practice 4880758887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-America Orthopedics LLCGroup PAC ID 1850455759, 30 clinicians

Practice addresses (Care Compare)

1923 N Webb Rd
Wichita, KS 67206-3405
Phone (316) 630-9300

1927 N Webb Rd
Wichita, KS 67206-3405
Phone (316) 630-9300

Merit-based Incentive Payment System (MIPS)

Final score
79.9 of 100Reported as group
Quality
62.85
Promoting interoperability
99
Improvement activities
40
Cost
70.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-America Orthopedics LLC CurrentSince Jan 1, 2009 Accepting new patients
Mid-America Orthopedics, P.a. Past Accepting new patients

Locations

1923 N Webb Rd
Wichita, KS 67206
Phone (316) 262-4886

Interoperability endpoints

  • Direct secure messaging: dane.stark.1@26355.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1114904083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063405",
            "telephone_number": "316-262-4886",
            "fax_number": "316-684-3326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063405",
            "telephone_number": "316-262-4886",
            "fax_number": "316-262-4887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2348 W Central Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "El Dorado",
            "state": "KS",
            "postal_code": "670423465",
            "country_code": "US",
            "telephone_number": "316-452-5033",
            "fax_number": "316-452-5053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STARK",
        "first_name": "DANE",
        "middle_name": "MICHAEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "1101792",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "01968",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.