Individual provider Active NPI

Marvin Pamatmat, CRNA

  • Certified Registered Nurse Anesthetist
  • Wichita, KS
National Provider Identifier
1598734535
Registry record updated Sep 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
54504 Issued in KS
Practice address
2610 N Woodlawn St
Wichita, KS 67220-2729
Phone
(316) 858-2610
NPI assigned
Mar 14, 2006
Last updated
Sep 13, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 54504 KS Primary

Addresses

Primary practice location

2610 N Woodlawn St
Wichita, KS 67220-2729

Mailing address

PO Box 3374
Wichita, KS 67201-3374
Phone (316) 685-6236

Other identifiers 1

IdentifierTypeStateIssuer
145043OtherKSBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040714001059 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052390069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Continent Anesthesiology CharteredGroup PAC ID 9830182575, 24 clinicians

Practice addresses (Care Compare)

550 N Hillside St
Wichita, KS 67214-4910
Phone (316) 789-8444

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Continent Anesthesiology Chartered CurrentSince Jun 30, 2021 Accepting new patients
Anesthesia Consulting Services, PA Past Accepting new patients

Locations

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

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 1

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189641600000",
    "number": "1598734535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3374",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672013374",
            "telephone_number": "316-685-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 N WOODLAWN ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672202729",
            "telephone_number": "316-858-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAMATMAT",
        "first_name": "MARVIN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2007-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "54504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "145043",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.