Individual provider Active NPI

Susan K Pfannenstiel, APRN

  • Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1609843515
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
45207 Issued in KS
Practice address
3211 S Seneca St
Wichita, KS 67217-3348
Phone
(316) 670-1582
NPI assigned
Mar 1, 2006
Last updated
Jul 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 45207 KS Primary

Addresses

Primary practice location

3211 S Seneca St
Wichita, KS 67217-3348

Mailing address

PO Box 932958
Cleveland, OH 44193-0028
Phone (316) 670-1582

Other identifiers 1

IdentifierTypeStateIssuer
100400060AMedicaidKS

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
I20040510001206 KS Practitioner - Nurse Practitioner 1052300563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
45207KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gracemed Health Clinic, Inc CurrentSince May 26, 2023 Accepting new patients
Gracemed Health Clinic Inc CurrentSince May 26, 2023 Accepting new patients
Hays Medical Center, Inc. Past Accepting new patients

Locations

1122 N Topeka St
Wichita, KS 67214
Phone (316) 263-7455

1150 N Broadway Ave
Wichita, KS 67214

4910 W 1st St N
Wichita, KS 67212

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1609843515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932958",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930028",
            "telephone_number": "316-670-1582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 S SENECA ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672173348",
            "telephone_number": "316-670-1582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFANNENSTIEL",
        "first_name": "SUSAN",
        "middle_name": "K",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "45207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100400060A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.