Individual provider Active NPI

Patrick W Stang, MD

  • Psychiatry Physician
  • Great Bend, KS
National Provider Identifier
1639100183
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0423629 Issued in KS
Practice address
5815 Broadway
Great Bend, KS 67530
Phone
(620) 792-2544
Fax
(620) 792-7052
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0423629 KS Primary

Addresses

Primary practice location

5815 Broadway
Great Bend, KS 67530

Mailing address

5815 Broadway
Great Bend, KS 67530
Phone (620) 792-2544

Other identifiers 1

IdentifierTypeStateIssuer
100098090AMedicaidKS

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050512000632 KS Practitioner - Psychiatry 6709827421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Kansas School of Med (KC/Wich/Sal), 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Center for Counseling and ConsultationGroup PAC ID 2961458518, 14 clinicians

Practice addresses (Care Compare)

5815 Broadway Ave
Great Bend, KS 67530-3123
Phone (620) 792-2544

Hospital & facility affiliations

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0423629KSMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Counseling and Consultation CurrentSince Jul 1, 1993 Accepting new patients

Locations

5815 Broadway Ave
Great Bend, KS 67530
Phone (620) 792-2544

Interoperability endpoints

  • Direct secure messaging: patrick.stang@khindirect.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1639100183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5815 BROADWAY",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "67530",
            "telephone_number": "620-792-2544",
            "fax_number": "620-792-7052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5815 BROADWAY",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "67530",
            "telephone_number": "620-792-2544",
            "fax_number": "620-792-7052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANG",
        "first_name": "PATRICK",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KS",
            "license": "0423629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100098090A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Bend, KS

Sources for this page

Verify at the official NPI Registry.