Individual provider Active NPI

Tony Van Vu, P.A.

  • Physician Assistant
  • Wichita, KS
National Provider Identifier
1356465991
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15-00891 Issued in KS
Practice address
7550 W Village Cir
Ste. 1
Wichita, KS 67205-9363
Phone
(316) 838-2020
Fax
(316) 838-7574
NPI assigned
Mar 19, 2007
Last updated
Jul 29, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15-00891 KS Primary

Addresses

Primary practice location

7550 W Village Cir
Ste. 1
Wichita, KS 67205-9363

Mailing address

7550 W Village Cir
Ste. 1
Wichita, KS 67205-9363
Phone (316) 838-2020

Other identifiers 2

IdentifierTypeStateIssuer
042990OtherKSBLUE CROSS BLUE SHIELD
200000900AMedicaidKS

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050511000918 KS Practitioner - Physician Assistant 2567402282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas Orthopaedic Center, PAGroup PAC ID 3577553668, 24 clinicians

Practice addresses (Care Compare)

7550 W Village Cir
Wichita, KS 67205-9364
Phone (316) 838-2020

7550 W Village Circle
Wichita, KS 67205-9364

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15-00891KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas Orthopaedic Center, P.a. CurrentSince Aug 27, 2013 Accepting new patients
Kansas Orthopaedic Center, P.a. CurrentSince Aug 27, 2013 Accepting new patients
Wichita Bone & Joint Center, PA Past Accepting new patients

Locations

101 E Fulton St
Garden City, KS 67846
Phone (620) 271-0700

7550 W Village Cir
Ste 1
Wichita, KS 67205
Phone (316) 838-2020

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, 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": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1356465991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7550 W VILLAGE CIR",
            "address_2": "STE. 1",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672059363",
            "telephone_number": "316-838-2020",
            "fax_number": "316-838-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7550 W VILLAGE CIR",
            "address_2": "STE. 1",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672059363",
            "telephone_number": "316-838-2020",
            "fax_number": "316-838-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VU",
        "first_name": "TONY",
        "middle_name": "VAN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-00891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "042990",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200000900A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.