Keley M Sulawske, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

15-02311 Issued in KS

Practice address

1515 S Clifton Ave Ste 400
Wichita, KS 67218-2961

Phone

(316) 274-1550

Fax

(316) 274-1569

NPI assigned

May 29, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Keley M Porter Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pearl OB/GYN, LLCGroup PAC ID 4880097898, 3 clinicians

Ascension Medical Group Via Christi PAGroup PAC ID 2961314497, 184 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Via Christi Hospitals Wichita, Inc. Hospital, Wichita, KS, CCN 170122

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24005/brand/2/csg/1/fhir/r4

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.

• Ascension Medical Group Via Christi, PA

  • Multi-Specialty Clinic/Center
  • Wichita, KS
  • NPI 1063453991
  Medicare reassignment Care Compare group NPD
• Pearl OBGYN LLC

  • Obstetrics & Gynecology Physician
  • Wichita, KS
  • NPI 1659949931
  Medicare reassignment Care Compare group NPD
• Pearl Girl Clinics LLC

  • Obstetrics & Gynecology Physician
  • Derby, KS
  • NPI 1376228049
  Medicare reassignment NPD
• Ascension Medical Group Via Christi, PA

  • Rural Health Clinic/Center
  • Wellington, KS
  • NPI 1538773569
  NPD
• Ascension Medical Group Via Christi, PA

  • Ambulatory Surgical Clinic/Center
  • Wichita, KS
  • NPI 1073523452
  NPD (past)
• Kingman County Family Medicine,LLC

  • Family Medicine Physician
  • Kingman, KS
  • NPI 1770785362
  NPD (past)

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

• Ascension Via Christi Hospitals Wichita Inc.

  • General Acute Care Hospital
  • Wichita, KS
  • NPI 1154314789
  Care Compare affiliation

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1346808094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8035",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672080035",
            "telephone_number": "316-689-9135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 S CLIFTON AVE STE 400",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672182961",
            "telephone_number": "316-274-1550",
            "fax_number": "316-274-1569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULAWSKE",
        "first_name": "KELEY",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-02311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELEY",
            "last_name": "PORTER",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Connie Faye Suderman, LSCSW
• Shanna Dawn Suderman, PA-C
• Suellentrop Physical Therapy LLC
• Erin Suellentrop, PT
• Alex J Suh, DC
• Suleman Sadiq
• Bushra Sulieman
• Eiman Bushra Ibnauf Sulieman, MD
• Sasha Danae Sullard, RN
• Sullivan Gang Care Center

• Physician Assistant in Wichita, KS
• Providers in Wichita, KS by specialty
• Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.