Individual provider Active NPI

John Eliveha, M.D.

  • Internal Medicine Physician
  • Wichita, KS
National Provider Identifier
1295186435
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
94-09039 Issued in KS
Practice address
1010 N Kansas St
Wichita, KS 67214-3124
Phone
(316) 293-1818
NPI assigned
Jun 29, 2016
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 94-09039 KS Primary

Addresses

Primary practice location

1010 N Kansas St
Wichita, KS 67214-3124

Mailing address

1010 N Kansas St
Wichita, KS 67214-3124
Phone (316) 293-1818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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 1

Enrollment IDStateProvider typePAC IDDetails
I20251018000384 NE Order and Referring Only - Critical Care (Intensivists)Practitioner - Critical Care (Intensivists) 9931494168

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9875NEMDMental Health Counselor
94-09039KSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kansas School of Medicine Wichita Medical Practice Assoc Internal Medicine CurrentSince Jul 24, 2022 Accepting new patients

Locations

1010 N Kansas St
Wichita, KS 67214
Phone (316) 293-2622

Organizations & group practices 1

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": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1295186435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N KANSAS ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143124",
            "telephone_number": "316-293-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N KANSAS ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143124",
            "telephone_number": "316-293-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIVEHA",
        "first_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "94-09039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.