Individual provider Active NPI

Andrew S Hentzen, MD

  • Surgery Physician
  • Wichita, KS
National Provider Identifier
1306007430
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
04-37420 Issued in KS
Practice address
3243 E Murdock St Ste 404
Wichita, KS 67208-3007
Phone
(316) 685-6222
NPI assigned
Jun 20, 2008
Last updated
Oct 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 04-37420 KS Primary

Addresses

Primary practice location

3243 E Murdock St Ste 404
Wichita, KS 67208-3007

Mailing address

3243 E Murdock St Ste 404
Wichita, KS 67208-3007
Phone (316) 685-6222

Other practice location 1

550 N Hillside St
Wichita, KS 67214-4910
Phone (316) 685-6222

Other practice location 2

9300 E 29th St N Ste 203
Wichita, KS 67226-2183
Phone (316) 685-6222

Other identifiers 1

IdentifierTypeStateIssuer
201110330MedicaidKS

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140904002659 KS Practitioner - General Surgery 1557519154 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas Surgical Consultants LLPGroup PAC ID 8224023445, 21 clinicians
Mid-Kansas Wound Specialist P aGroup PAC ID 3678562147, 17 clinicians

Practice addresses (Care Compare)

3243 E Murdock St
Suite 404
Wichita, KS 67208-3007
Phone (316) 685-6222

550 N Hillside St
Wichita, KS 67214-4910
Phone (316) 962-2239

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy37
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux25
Melanoma (skin cancer) excision1-10
Removal of tissue196
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas Surgical Consultants, LLP Surgery CurrentSince Aug 15, 2014 Accepting new patients
Mid-Kansas Wound Specialist P a CurrentSince Feb 15, 2021 Accepting new patients
Central Plains Cardiothoracic Surgery, LLC PastSince Aug 15, 2014 Accepting new patients
Wesley Medical Center LLC Past Accepting new patients

Locations

10346 E Stonegate Ln
Ste 100
Wichita, KS 67206
Phone (316) 871-0995

2610 N Woodlawn Blvd
Wichita, KS 67220
Phone (316) 684-3838

3243 E Murdock St
Ste 404
Wichita, KS 67208
Phone (316) 685-6222

3243 E Murdock St
Ste 4404
Wichita, KS 67208

550 N Hillside St
Wichita, KS 67214
Phone (316) 688-2239

929 N Saint Francis Ave
Wichita, KS 67214
Phone (316) 291-4396

9300 E 29th St N
Ste 203
Wichita, KS 67226
Phone (316) 219-9360

Interoperability endpoints

  • Direct secure messaging: andrewhentzen@ksc.allscriptsdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1306007430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3243 E MURDOCK ST STE 404",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672083007",
            "telephone_number": "316-685-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3243 E MURDOCK ST STE 404",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672083007",
            "telephone_number": "316-685-6222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 N Hillside St",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672144910",
            "country_code": "US",
            "telephone_number": "316-685-6222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9300 E 29th St N Ste 203",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672262183",
            "country_code": "US",
            "telephone_number": "316-685-6222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENTZEN",
        "first_name": "ANDREW",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-20",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KS",
            "license": "04-37420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201110330",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.