Individual provider Active NPI

Angela Suzanne Holdeman, MD

  • Obstetrics & Gynecology Physician
  • Wichita, KS
National Provider Identifier
1447455993
Registry record updated May 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
04-33512 Issued in KS
Practice address
550 N Hillside St
Wichita, KS 67214-4910
Phone
(316) 962-6818
NPI assigned
Jun 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 04-33512 KS Primary

Addresses

Primary practice location

550 N Hillside St
Wichita, KS 67214-4910

Mailing address

3340 E Central Ave Ste 200
Wichita, KS 67208-3104
Phone (316) 962-6818

Other identifiers 1

IdentifierTypeStateIssuer
200733930AMedicaidKS

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
I20110721000127 KS Practitioner - Obstetrics/Gynecology 6709054547 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Kansas School of Med (KC/Wich/Sal), 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wesley Physicians Medical Specialties LLCGroup PAC ID 1355509886, 50 clinicians

Practice addresses (Care Compare)

550 N Hillside Ave
Wesley Medical Center
Wichita, KS 67214-4910
Phone (316) 962-2000

Merit-based Incentive Payment System (MIPS)

Final score
84.77 of 100Reported as group
Quality
77.19
Promoting interoperability
99
Improvement activities
40
Cost
72.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-33512KSMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wesley Physicians Medical Specialties LLC CurrentSince Aug 13, 2019 Accepting new patients
Heartland Women'S Group at Wesley LLC Obstetrics & Gynecology CurrentSince Apr 23, 2019 Accepting new patients
Wesley Medical Center LLC Obstetrics & Gynecology Past Accepting new patients

Locations

3243 E Murdock St
Ste Lvl-G
Wichita, KS 67208
Phone (316) 962-3100

2600 N Woodlawn Blvd
Wichita, KS 67220
Phone (316) 260-1690

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

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

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.

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1447455993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E CENTRAL AVE STE 200",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672083104",
            "telephone_number": "316-962-6818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 N HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144910",
            "telephone_number": "316-962-6818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDEMAN",
        "first_name": "ANGELA",
        "middle_name": "SUZANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "KS",
            "license": "04-33512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200733930A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.