Samuel Akidiva, MD
Individual provider Active NPI Internal Medicine Physician · Wichita, KS
NPI 1447562152 · NPPES record last updated Jan 22, 2024
Key facts
- NPI
- 1447562152
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 04-36391 (KS)
- Practice address
- 1010 N Kansas St
Wichita, KS 67214-3124 - Phone
- (316) 293-1840
- Fax
- (316) 293-1866
- NPI assigned
- Jul 10, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Hospitalist
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University of Kansas School of Medicine Wichita Medical Practice Assoc
Hutchinson Regional Medical Center Inc
Practice addresses (Care Compare)
1010 N Kansas St
Wichita, KS 67214-3124
1701 E 23Rd Ave
Hutchinson, KS 67502-1105
Hospital & facility affiliations
- Hutchinson Regional Medical Center Inc
- Ascension Via Christi Hospitals Wichita, Inc.
- McPherson Hospital
- Summit Surgical, LLC
- Hospital District #1 of Rice County
- Hutchinson Hospital Corp
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131101000032 | KS | Practitioner - Hospitalist |
6608022074 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-36391 | KS | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hutchinson Regional Medical Center, Inc. | Current | Accepting new patients | |
| Hutchinson Regional Medical Center, Inc. | Current |
Accepting new patients | |
| Hutchinson Regional Medical Center, Inc. | Current |
Accepting new patients | |
| Ascension Via Christi Hospitals Wichita Inc. | Past | Accepting new patients | |
| Hutchinson Regional Medical Center, Inc. | Past | Accepting new patients |
Locations
1701 E 23rd Ave
Hutchinson, KS 67502
Phone (620) 665-2117
Interoperability endpoints
- samuel.akidiva@khindirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 04-36391 | KS | Yes |
Addresses
Primary practice location
1010 N Kansas St
Wichita, KS 67214-3124
Mailing address
PO Box 1358
Wichita, KS 67201-1358
Phone (316) 293-3429
Other practice location 1
929 N Saint Francis Ave
Wichita, KS 67214-3821
Phone (316) 293-2611
Other practice location 2
3600 E Harry St
Wichita, KS 67218-3713
Phone (316) 293-2611
Other practice location 3
550 N Hillside St
Wichita, KS 67214-4910
Phone (316) 293-2611
Other providers in Wichita, KS
- Rose Ndululu Aiyenowo
- Omotolu Olaitan Aje-Omokore
- Kristen Michelle Akers
- Scott Akers
- Esther Akidiva
- Tayler Akin
- Brooke Akins
- Monday T Akintuyi
- Abdul Rahman Akkawi
- Ekerette U Akpan
All providers in Wichita, KS · Internal Medicine Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.