Individual provider Active NPI

Obada Tayyem, MD

  • Gastroenterology Physician
  • Wichita, KS
National Provider Identifier
1487006672
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
04-45885 Issued in KS
Practice address
3121 N Webb Rd
Wichita, KS 67226-8119
Phone
(316) 928-8930
Fax
(316) 261-3275
NPI assigned
Jul 12, 2016
Last updated
Oct 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 04-45885 KS Primary

Addresses

Primary practice location

3121 N Webb Rd
Wichita, KS 67226-8119

Mailing address

3121 N Webb Rd Ste 101
Wichita, KS 67226-8119
Phone (316) 261-3130

Other identifiers 1

IdentifierTypeStateIssuer
30004810520001MedicaidKS

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
I20220705000170 KS Practitioner - Internal Medicine 8527448802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kansas Gastroenterology LLCGroup PAC ID 1355242975, 20 clinicians

Practice addresses (Care Compare)

3121 N Webb Rd
Suite 101
Wichita, KS 67226-8119
Phone (316) 928-8930

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy100
Upper gastrointestinal (GI) endoscopy for acid reflux211

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas Gastroenterology LLC Gastroenterology CurrentSince Jul 1, 2022 Accepting new patients
Kansas Endoscopy LLC PastSince Jul 1, 2022 Accepting new patients

Locations

3121 N Webb Rd
Wichita, KS 67226
Phone (316) 261-3130

3121 N Webb Rd
Ste 101
Wichita, KS 67226
Phone (316) 261-3130

3121 N Webb Rd
Ste 107
Wichita, KS 67226
Phone (316) 219-2828

Interoperability endpoints

  • FHIR API: https://e38455df-8137-43ad-9077-b36c0bc0745d.gastro.prod.fhir.ema-api.com/fhir/r4/

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1487006672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 N WEBB RD STE 101",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672268119",
            "telephone_number": "316-261-3130",
            "fax_number": "316-261-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672268119",
            "telephone_number": "316-928-8930",
            "fax_number": "316-261-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYYEM",
        "first_name": "OBADA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-12",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KS",
            "license": "04-45885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30004810520001",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.