NPIMap

Individual provider Active NPI

Lesa Fuller

  • Acute Care Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1669136479
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
53-80532 Issued in KS
Practice address
9350 E 35TH St N Ste 101
Wichita, KS 67226-2022
Phone
(315) 265-1308
Fax
(316) 265-4480
NPI assigned
Oct 27, 2021
Last updated
Mar 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 53-80532 KS Primary

Addresses

Primary practice location

9350 E 35TH St N Ste 101
Wichita, KS 67226-2022

Mailing address

9350 E 35TH St N Ste 101
Wichita, KS 67226-2022
Phone (316) 265-1308

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cardiovascularcare@protonmail.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220202000338 KS Practitioner - Nurse Practitioner 6406249143 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas Heart Hospital, LLCGroup PAC ID 6204735947, 27 clinicians

Practice addresses (Care Compare)

9350 E 35TH St N
101 Cardiovascular Consultants of KS
Wichita, KS 67226-2022
Phone (316) 630-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53-80532KSMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Cardiology, LLC CurrentSince Jan 1, 2022 Accepting new patients
Kansas Heart Hospital, LLC CurrentSince Feb 2, 2025 Accepting new patients
Heartland Cardiology, LLC CurrentSince Jan 1, 2022 Accepting new patients
Richard a Steckley MD PA CurrentSince Mar 31, 2023 Accepting new patients
Layne M Reusser MD PA CurrentSince Mar 31, 2023 Accepting new patients
Christian a. Hourani, MD, PA CurrentSince Mar 31, 2023 Accepting new patients
Jason T Tauke MD PA CurrentSince Mar 31, 2023 Accepting new patients
Bassem M Chehab MD PA CurrentSince Mar 31, 2023 Accepting new patients
Aziz R Maksoud MD PA CurrentSince Mar 31, 2023 Accepting new patients
Kansas Heart Hospital, LLC CurrentSince Feb 2, 2025 Accepting new patients

Locations

3535 N Webb Rd
Wichita, KS 67226
Phone (316) 260-4491

3601 N Webb Rd
Wichita, KS 67226
Phone (316) 360-5000

9000 W Central Ave
Wichita, KS 67212
Phone (316) 686-5300

9350 E 35th St N
Ste 101
Wichita, KS 67226
Phone (316) 265-1308

Interoperability endpoints

  • Direct secure messaging: lesa.fuller.1@29422.direct.athenahealth.com

Organizations & group practices 11

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.

Hospital & facility affiliations 8

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": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1669136479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9350 E 35TH ST N STE 101",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672262022",
            "telephone_number": "316-265-1308",
            "fax_number": "316-265-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9350 E 35TH ST N STE 101",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672262022",
            "telephone_number": "315-265-1308",
            "fax_number": "316-265-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "LESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-27",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KS",
            "license": "53-80532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cardiovascularcare@protonmail.com",
            "affiliation": "N",
            "address_1": "9350 E 35th St N Ste 101",
            "city": "Wichita",
            "state": "KS",
            "country_code": "US",
            "postal_code": "672262022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.