Gregory Thomas Bongers, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

04-26353 Issued in KS

Practice address

1101 N Rock Rd
Derby, KS 67037-3705

Phone

(316) 788-6963

Fax

(316) 788-5373

NPI assigned

Apr 20, 2006

Last updated

Jul 14, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Kansas School of Med (KC/Wich/Sal), 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Medcenters PAGroup PAC ID 4688568751, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Phoenix Home Care Home health agency, Wichita, KS, CCN 178012
• Ascension at Home Home health agency, Wichita, KS, CCN 177117
• Rock Regional Hospital, LLC Hospital, Derby, KS, CCN 170204

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: gregorybongers@fmcpa.allscriptsdirect.net

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.

• Family Medcenters, P.a.

  • Family Medicine Physician
  • Derby, KS
  • NPI 1285688358
  Medicare reassignment Care Compare group
• Kansas Imaging Consultants, PA

  • Diagnostic Radiology Physician
  • Wichita, KS
  • NPI 1841267663
  NPD (past)

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

• Proactive Home Care, LLC

  dba Phoenix Home Care

  • Home Health Agency
  • Wichita, KS
  • NPI 1013979905
  Care Compare affiliation
• Via Christi Home Health Wichita, LLC

  dba Ascension at Home

  • Home Health Agency
  • Wichita, KS
  • NPI 1235132119
  Care Compare affiliation

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215993600000",
    "number": "1629033519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N ROCK RD",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670373705",
            "telephone_number": "316-788-6963",
            "fax_number": "316-788-5373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N ROCK RD",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670373705",
            "telephone_number": "316-788-6963",
            "fax_number": "316-788-5373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONGERS",
        "first_name": "GREGORY",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2008-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-26353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Shelbi Bish
• Rachel Renee Blasi, M.A., CCC-SLP
• Breanna Bobbit
• Cody L Bobbit, DPT
• Todd J Bohnen, COTA
• Beirut M. Bonham, CLD
• Traci Lynn Borland, OTR/L
• Brandi K Brace, CPM
• Brackeen Chiropractic PA
• Paul Allen Brackeen, D.C.

• Family Medicine Physician in Derby, KS
• Providers in Derby, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.