Michael Paul Ohlde, PSYD, LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2156 Issued in KS

Practice address

250 N Rock Rd Ste 170
Wichita, KS 67206-2287

Phone

(316) 358-7257

Fax

(316) 358-7002

NPI assigned

Jul 14, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mike Ohlde Other name

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kansas Cognitive Center

  • Community/Behavioral Health Agency
  • Wichita, KS
  • NPI 1013599042
  NPD
• South Central Mental Health Counseling Center, Inc.

  • Community/Behavioral Health Agency
  • El Dorado, KS
  • NPI 1891561858
  NPD (past)

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

{
    "created_epoch": "1184371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1255530788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N ROCK RD STE 170",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672062287",
            "telephone_number": "316-358-7257",
            "fax_number": "316-358-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 N ROCK RD STE 170",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672062287",
            "telephone_number": "316-358-7257",
            "fax_number": "316-358-7002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "727 N Waco Ave",
            "address_2": "Suite 320",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672033951",
            "country_code": "US",
            "telephone_number": "316-616-0260 x107",
            "fax_number": "316-616-0264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OHLDE",
        "first_name": "MICHAEL",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PSYD, LP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-14",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "2156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2007707108",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12522771",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIKE",
            "last_name": "OHLDE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Ohana Malama Healthcare Services LLC
• Constance Kay Ohler, LSCSW, LCAC
• Evan C Ohlman, PA-C
• Kaitlyn Marie Ohlman, RN
• Luisa M Ohm, APRN
• Sarah Ohm

• Clinical Psychologist in Wichita, KS
• Providers in Wichita, KS by specialty
• Clinical Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.

Verify at the official NPI Registry.