Wichita Urology Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

WICHITA UROLOGY SURGERY CENTER LLC

Practice address

2620 N Webb Rd
Wichita, KS 67226-8110

Phone

(316) 636-6176

NPI assigned

Jun 3, 2021

Last updated

Nov 13, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer L Ale-Ebrahim, MHA

Title

Executive Director

Phone

(316) 636-6110

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Listed as

Wichita Urology Surgery Center LLCCCN 17C0001896

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gregory F Byrd, MD

  • Urology Physician
  • Wichita, KS
  • NPI 1376619734
  NPD (past)
• Jeffrey S Davis, MD

  • Urology Physician
  • Wichita, KS
  • NPI 1073773008
  NPD (past)
• Ayham J Farha, MD

  • Urology Physician
  • Wichita, KS
  • NPI 1982682753
  NPD (past)
• Jonathan Andrew Jensen, M.D.

  • Urology Physician
  • Wichita, KS
  • NPI 1760825137
  NPD (past)
• Fadi N Joudi, MD

  • Urology Physician
  • Wichita, KS
  • NPI 1427050079
  NPD (past)
• Surendra Kolla, MD

  • Urology Physician
  • Wichita, KS
  • NPI 1194952143
  NPD (past)
• Philippe Nabbout, MD

  • Urology Physician
  • Wichita, KS
  • NPI 1811276801
  NPD (past)
• Trang Pham, M.D.

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Wichita, KS
  • NPI 1932596681
  NPD (past)
• Tim Alan Richardson, MD

  • Urology Physician
  • Wichita, KS
  • NPI 1508985417
  NPD (past)
• Kahlil Nabil Saad, M.D.

  • Urology Physician
  • Wichita, KS
  • NPI 1023351905
  NPD (past)
• George F Zakharia, MD

  • Urology Physician
  • Wichita, KS
  • NPI 1174501951
  NPD (past)
• Patrick Houghton, MD

  • Urology Physician
  • Jacksonville, FL
  • NPI 1922531383
  NPD (past)

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1245806876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672268110",
            "telephone_number": "316-358-0813",
            "fax_number": "316-358-0314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672268110",
            "telephone_number": "316-636-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHITA UROLOGY SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-03",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "ALE-EBRAHIM",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "316-636-6110",
        "authorized_official_credential": "MHA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wichita Therapy Stop
• Wichita Tran4Mation LLC
• Wichita Trauma & Surgical Critical Care Associates LLC
• Wichita Treatment Center, Inc
• Wichita Urology Group P.a.
• Wichita Vascular and Vein Center, LLC (Wichita Vascular and Vein Center)
• Wichita Vision Institute P.a.
• Wichita Wellness and Rehab LLC.
• Wichita Women's Initiative Network
• Asher J Wickell, LCMFT

• Ambulatory Surgical Clinic/Center in Wichita, KS
• Providers in Wichita, KS by specialty
• Ambulatory Surgical Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.