Active NPI
Surendra Kolla, MD
- Urology Physician
- Wichita, KS
National Provider Identifier
1194952143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 04-37597
- Practice address
- 3311 E Murdock St
Wichita, KS 67208-3054 - Phone
- (316) 689-9185
- NPI assigned
- Jun 17, 2009
- Last updated
- Jul 7, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Urology Physician | 208800000X | 04-37597 | KS | Primary |
Addresses
Primary practice location
3311 E Murdock St
Wichita, KS 67208-3054
Mailing address
3311 E Murdock St
Wichita, KS 67208-3054
Phone (316) 689-9185
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A122586 | Other | CA | MEDICAL LICENSE NUMBER |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2626 N Webb Rd
Wichita, KS 67226-8110
Phone (316) 636-6100
Hospital & facility affiliations
- Ascension Via Christi Hospitals Wichita, Inc.
- Wesley Medical Center
- Kansas Medical Center LLC
- Via Christi Hospital Wichita St Teresa, Inc
- Pratt Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.45 of 100
- Promoting interoperability
- 97
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 29 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-37597 | KS | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wichita Urology Surgery Center LLC | Past | Accepting new patients | |
| Kansas Spine Anesthesia Corporation PA | Past | Accepting new patients |
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.
-
- Urology Physician
- Wichita, KS
- NPI 1639157498
-
- Pain Medicine (Anesthesiology) Physician
- Wichita, KS
- NPI 1720345911
-
- Ambulatory Surgical Clinic/Center
- Wichita, KS
- NPI 1245806876
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Wichita, KS
- NPI 1023334950
-
- General Acute Care Hospital
- Wichita, KS
- NPI 1154314789
-
- General Acute Care Hospital
- Andover, KS
- NPI 1255380127
-
dba Pratt Regional Medical Center
- Rural Acute Care Hospital
- Pratt, KS
- NPI 1578596904
-
dba Wesley Medical Center
- General Acute Care Hospital
- Wichita, KS
- NPI 1447299649
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436227200000",
"number": "1194952143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3311 E MURDOCK ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672083054",
"telephone_number": "316-689-9185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3311 E MURDOCK ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672083054",
"telephone_number": "316-689-9185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLLA",
"first_name": "SURENDRA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-17",
"last_updated": "2015-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "KS",
"license": "04-37597",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE NUMBER",
"identifier": "A122586",
"state": "CA"
}
],
"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 Jul 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.