Individual provider Active NPI

Andrew Declerk, MD

  • Vascular Surgery Physician
  • Wichita, KS
National Provider Identifier
1124511399
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
04-50892 Issued in KS
Practice address
9350 E 35TH St N Ste 103
Wichita, KS 67226-2022
Phone
(316) 263-0296
NPI assigned
Jun 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 04-50892 KS Primary
Surgery Physician 208600000X 04-50892 KS

Addresses

Primary practice location

9350 E 35TH St N Ste 103
Wichita, KS 67226-2022

Mailing address

551 N Hillside St Ste 201
Wichita, KS 67214-4925
Phone (316) 263-0296

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250723002613 KS Practitioner - Vascular Surgery 1456600162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wichita Surgical Specialists PAGroup PAC ID 6507840634, 60 clinicians

Practice addresses (Care Compare)

9350 E 35TH N
Suite 103
Wichita, KS 67226-2016
Phone (316) 858-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-50892KSMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wichita Surgical Specialists PA Surgery CurrentSince Aug 1, 2025 Accepting new patients
Meritas Health Corporation PastSince Aug 1, 2025 Accepting new patients

Locations

551 N Hillside St
Ste 201
Wichita, KS 67214
Phone (316) 263-0296

9350 E 35th St N
Ste 103
Wichita, KS 67226
Phone (316) 858-5000

818 N Emporia St
Ste 200
Wichita, KS 67214
Phone (316) 263-0296

Interoperability endpoints

  • Direct secure messaging: andrew.declerk@hca3.eclinicaldirectplus.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.

Hospital & facility affiliations 5

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": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1124511399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 N HILLSIDE ST STE 201",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144925",
            "telephone_number": "316-263-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9350 E 35TH ST N STE 103",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672262022",
            "telephone_number": "316-263-0296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECLERK",
        "first_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-12",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "KS",
            "license": "04-50892",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KS",
            "license": "04-50892",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.