Individual provider Active NPI

Jerry G Gaston, DO

  • Surgery Physician
  • Wichita, KS
National Provider Identifier
1356340178
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
05-23472 Issued in KS
Practice address
4013 N Ridge Rd
Ste 210
Wichita, KS 67205-8860
Phone
(316) 945-7309
Fax
(316) 945-9131
NPI assigned
Jul 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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 05-23472 KS Primary

Addresses

Primary practice location

4013 N Ridge Rd
Ste 210
Wichita, KS 67205-8860

Mailing address

PO Box 905
Wichita, KS 67201-0905
Phone (316) 945-7309

Other identifiers 1

IdentifierTypeStateIssuer
100189280AMedicaidKS

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
I20050421000680 KS Practitioner - General Surgery 2365480118 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wichita Surgical Specialists PAGroup PAC ID 6507840634, 60 clinicians

Practice addresses (Care Compare)

818 N Emporia St
Suite 200
Wichita, KS 67214-3726
Phone (316) 263-0296

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy242
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)28
Upper gastrointestinal (GI) endoscopy for acid reflux105
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wichita Surgical Specialists PA Surgery CurrentSince Sep 1, 2024 Accepting new patients
Ridgewood Surgery and Endoscopy Center LLC PastSince Apr 30, 2003 Accepting new patients

Locations

818 N Emporia St
Ste 200
Wichita, KS 67214
Phone (316) 263-0296

551 N Hillside St
Ste 201
Wichita, KS 67214
Phone (316) 263-0296

9350 E 35th St N
Ste 103
Wichita, KS 67226
Phone (316) 858-5000

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1356340178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 905",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672010905",
            "telephone_number": "316-945-7309",
            "fax_number": "316-945-9131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4013 N RIDGE RD",
            "address_2": "STE 210",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672058860",
            "telephone_number": "316-945-7309",
            "fax_number": "316-945-9131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASTON",
        "first_name": "JERRY",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KS",
            "license": "05-23472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100189280A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.