Ashley Rae Vonada, PA-C

Individual provider Active NPI Physician Assistant · Great Bend, KS

NPI 1609200088 · NPPES record last updated Jul 28, 2022

Key facts

NPI
1609200088
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
T03766 (KS)
Practice address
3515 Broadway Ave
Great Bend, KS 67530-3633
Phone
(620) 792-2511
Fax
(620) 786-6262
NPI assigned
Aug 21, 2013
Sex
Female
Sole proprietor
No

Organizations & group practices 7

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 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ukhs Great Bend LLC (64 clinicians)

Practice addresses (Care Compare)

3515 Broadway Ave
Great Bend, KS 67530-3633
Phone (620) 786-6515

Hospital & facility affiliations

  • University of KS HLTH System Great Bend Campus Hospital · Great Bend, KS · CCN 170191

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: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20131112001840 KS Practitioner - Physician Assistant 1355577834

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
T03766KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hays Medical Center, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X T03766 KS Yes

Addresses

Primary practice location

3515 Broadway Ave
Great Bend, KS 67530-3633

Mailing address

3515 Broadway Ave
Great Bend, KS 67530-3633
Phone (620) 792-2511

Other names

  • Ashley Rae Moore Former name

Other providers in Great Bend, KS

All providers in Great Bend, KS · Physician Assistant in Kansas

Sources for this page

Verify at the official NPI Registry.