NPIMap

Individual provider Active NPI

Jordan Moeder, PA-C

  • Physician Assistant
  • Wichita, KS
National Provider Identifier
1144994906
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15-02866 Issued in KS
Practice address
9828 E Shannon Woods Cir Ste 100
Wichita, KS 67226-4100
Phone
(316) 631-1600
NPI assigned
Aug 5, 2021
Last updated
Mar 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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 15-02866 KS Primary

Addresses

Primary practice location

9828 E Shannon Woods Cir Ste 100
Wichita, KS 67226-4100

Mailing address

9828 E Shannon Woods Cir Ste 100
Wichita, KS 67226-4100
Phone (316) 631-1600

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
I20240129001511 KS Practitioner - Physician Assistant 9830542638 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Orthopaedic Associates, P.a.Group PAC ID 1850285057, 47 clinicians

Practice addresses (Care Compare)

1323 N a St
Wellington, KS 67152-4350
Phone (316) 631-1600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15-02866KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Orthopaedic Associates, P.a. CurrentSince Jul 28, 2025 Accepting new patients
Kansas Orthopaedic Center, P.a. CurrentSince Jan 9, 2024 Accepting new patients

Locations

7550 W Village Cir
Ste 1
Wichita, KS 67205
Phone (316) 838-2020

Organizations & group practices 3

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 6

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": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1144994906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9828 E SHANNON WOODS CIR STE 100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672264100",
            "telephone_number": "316-631-1600",
            "fax_number": "316-631-1617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9828 E SHANNON WOODS CIR STE 100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672264100",
            "telephone_number": "316-631-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOEDER",
        "first_name": "JORDAN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-05",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-02866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.