Individual provider Active NPI

Fadi Jamil Odeh Al Muhaisen

  • Pediatric Endocrinology Physician
  • Wichita, KS
National Provider Identifier
1164710026
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
04-39743 Issued in KS
Practice address
3243 E Murdock St
Wichita, KS 67208-3052
Phone
(316) 500-8900
Fax
(816) 302-9939
NPI assigned
Jul 13, 2011
Last updated
Nov 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X 2015011039 MO
Pediatric Endocrinology Physician 2080P0205X 04-39743 KS Primary

Addresses

Primary practice location

3243 E Murdock St
Wichita, KS 67208-3052

Mailing address

2401 Gillham Rd
Provider Enrollment Dept
Kansas City, MO 64108-4619
Phone (816) 701-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170719000946 MO Practitioner - EndocrinologyPractitioner - Pediatric Medicine 8527338896 Reassigns benefits to 1 organization
I20170719002336 KS Practitioner - EndocrinologyPractitioner - Pediatric Medicine 8527338896 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-39743KSMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Children's Mercy Hospital CurrentSince Jul 3, 2017 Accepting new patients
The Children's Mercy Hospital Pediatrics CurrentSince Jul 3, 2017 Accepting new patients
The Children's Mercy Hospital Past Accepting new patients

Locations

5808 W 110th St
Overland Park, KS 66211
Phone (913) 696-8000

3243 E Murdock St
Wichita, KS 67208
Phone (316) 500-8900

3243 E Murdock St
Ste 201
Wichita, KS 67208
Phone (316) 500-8900

2401 Gillham Rd
Kansas City, MO 64108
Phone (816) 234-3380

Interoperability endpoints

  • Direct secure messaging: falmuhaisen99519@stormontvaildirect.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1164710026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "address_2": "PROVIDER ENROLLMENT DEPT",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-701-5200",
            "fax_number": "816-302-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3243 E MURDOCK ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672083052",
            "telephone_number": "316-500-8900",
            "fax_number": "816-302-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL MUHAISEN",
        "first_name": "FADI",
        "middle_name": "JAMIL ODEH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-13",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "MO",
            "license": "2015011039",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "KS",
            "license": "04-39743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.