Individual provider Active NPI

Tasneim Jesri, PA

  • Physician Assistant
  • Wichita, KS
National Provider Identifier
1669352530
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PENDING Issued in KS
Practice address
8451 E Pawnee St
Wichita, KS 67207-5420
Phone
(316) 618-0035
Fax
(316) 633-4468
NPI assigned
Sep 3, 2025
Last updated
Sep 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PENDING KS Primary

Addresses

Primary practice location

8451 E Pawnee St
Wichita, KS 67207-5420

Mailing address

8451 E Pawnee St
Wichita, KS 67207-5420
Phone (316) 618-0035

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
I20251017003595 KS Practitioner - Physician Assistant 5890282271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Kansas School of Med (KC/Wich/Sal), 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Montoya Family Practice, PAGroup PAC ID 7416021589, 4 clinicians

Practice addresses (Care Compare)

8451 E Pawnee St
Wichita, KS 67207-5420
Phone (316) 618-0035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PENDINGKSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Montoya Family Practice, PA Physician Assistant CurrentSince Sep 1, 2025 Accepting new patients

Locations

8451 E Pawnee St
Wichita, KS 67207
Phone (316) 618-0035

311 Arsenal St
Watertown, MA 02472
Phone (617) 924-5100

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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, 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": "1756857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1669352530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8451 E PAWNEE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672075420",
            "telephone_number": "316-618-0035",
            "fax_number": "316-633-4468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8451 E PAWNEE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672075420",
            "telephone_number": "316-618-0035",
            "fax_number": "316-633-4468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESRI",
        "first_name": "TASNEIM",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-03",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.