Active NPI
Lydia R Renich, PA
- Physician Assistant
- Wichita, KS
National Provider Identifier
1659564409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 15-01082
- Practice address
- 3121 N Webb Rd
Suite 101
Wichita, KS 67226-8119 - Phone
- (316) 261-3130
- Fax
- (316) 261-3275
- NPI assigned
- Aug 24, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 15-01082 | KS | Primary |
Addresses
Primary practice location
3121 N Webb Rd
Suite 101
Wichita, KS 67226-8119
Mailing address
3121 N Webb Rd
Suite 101
Wichita, KS 67226-8119
Phone (316) 261-3130
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200566420B | Medicaid | KS |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | LydiaRenich@ksgastro.direct.emds.com | Direct | |
| Direct Messaging Address | ksgastro@directaddress.net | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3121 N Webb Rd
Wichita, KS 67226-8119
Phone (316) 928-8930
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15-01082 | KS | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michelle R Brown M.D. P.a. | Past | Accepting new patients | |
| Aircapitalcardiology, PA | Past | Accepting new patients | |
| Kansas Endoscopy LLC | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/5687/brand/1/csg/1/fhir/r4
- lydiarenich@ksgastro.direct.emds.com
- lydia.renich@khindirect.org
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 and National Provider Directory roles.
-
- Gastroenterology Physician
- Wichita, KS
- NPI 1477547727
-
- Cardiovascular Disease Physician
- Wichita, KS
- NPI 1356641104
-
- Ambulatory Surgical Clinic/Center
- Wichita, KS
- NPI 1538153887
-
- Cardiovascular Disease Physician
- Wichita, KS
- NPI 1871536128
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620864000000",
"number": "1659564409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3121 N WEBB RD",
"address_2": "SUITE 101",
"city": "WICHITA",
"state": "KS",
"postal_code": "672268119",
"telephone_number": "316-261-3130",
"fax_number": "316-261-3275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3121 N WEBB RD",
"address_2": "SUITE 101",
"city": "WICHITA",
"state": "KS",
"postal_code": "672268119",
"telephone_number": "316-261-3130",
"fax_number": "316-261-3275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENICH",
"first_name": "LYDIA",
"middle_name": "R",
"name_prefix": "Ms.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-24",
"last_updated": "2021-05-13",
"certification_date": "2021-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KS",
"license": "15-01082",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200566420B",
"state": "KS"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "LydiaRenich@ksgastro.direct.emds.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3121 N Webb Rd",
"address_2": "Suite 101",
"city": "Wichita",
"state": "KS",
"country_code": "US",
"postal_code": "672268119",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ksgastro@directaddress.net",
"affiliation": "N",
"endpointDescription": "direct messaging address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "3121 N Webb Rd",
"address_2": "Suite 101",
"city": "Wichita",
"state": "KS",
"country_code": "US",
"postal_code": "672268119",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 May 13, 2021; 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.