Individual provider Active NPI

Meklit Zetawos, P.A.

  • Physician Assistant
  • Wichita, KS
National Provider Identifier
1528305372
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1501207 Issued in KS
Practice address
551 N Hillside St
Ste. 410
Wichita, KS 67214-4923
Phone
(316) 686-5300
Fax
(316) 651-2660
NPI assigned
Jan 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 1501207 KS Primary

Addresses

Primary practice location

551 N Hillside St
Ste. 410
Wichita, KS 67214-4923

Mailing address

551 N Hillside St
Ste. 410
Wichita, KS 67214-4923
Phone (316) 686-5300

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
I20141015000557 KS Practitioner - Physician Assistant 2961623004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
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
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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1501207KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas Endoscopy LLC Past Accepting new patients
Heartland Cardiology, PA Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GCHGAA

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.

Hospital & facility affiliations 2

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": "1358121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1528305372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 N HILLSIDE ST",
            "address_2": "STE. 410",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144923",
            "telephone_number": "316-686-5300",
            "fax_number": "316-651-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 N HILLSIDE ST",
            "address_2": "STE. 410",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144923",
            "telephone_number": "316-686-5300",
            "fax_number": "316-651-2660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZETAWOS",
        "first_name": "MEKLIT",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "1501207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.