NPIMap

Individual provider Active NPI

Tim Alan Richardson, MD

  • Urology Physician
  • Wichita, KS
National Provider Identifier
1508985417
Registry record updated Jul 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
04-35760 Issued in KS
Practice address
2626 N Webb Rd
Wichita, KS 67226-8110
Phone
(316) 636-6100
Fax
(316) 636-5813
NPI assigned
Mar 29, 2007
Last updated
Jul 10, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 04-35760 KS Primary

Addresses

Primary practice location

2626 N Webb Rd
Wichita, KS 67226-8110

Mailing address

2626 N Webb Rd
Wichita, KS 67226-8110
Phone (316) 636-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120904000284 KS Practitioner - Urology 5890865695 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Kansas School of Med (KC/Wich/Sal), 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wichita Urology Group PAGroup PAC ID 7214904499, 29 clinicians

Practice addresses (Care Compare)

2626 N Webb Rd
Wichita, KS 67226-8110
Phone (316) 636-6100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-35760KSMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wichita Urology Surgery Center LLC Past Accepting new patients
Kansas Spine Anesthesia Corporation PA Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Kansas Surgery and Recovery CenterWichita, KS, CCN 170183 Hospital Limited Partnership Interest (0.21%) Oct 20, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 7

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": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341878400000",
    "number": "1508985417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672268110",
            "telephone_number": "316-636-6100",
            "fax_number": "316-636-5813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672268110",
            "telephone_number": "316-636-6100",
            "fax_number": "316-636-5813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "TIM",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2012-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "KS",
            "license": "04-35760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.