Individual provider Active NPI

Elizabeth Kelley Wegner-Busch, PA-C

  • Medical Physician Assistant
  • Manhattan, KS
National Provider Identifier
1679728380
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1501273 Issued in KS
Practice address
4101 Anderson Ave
Manhattan, KS 66503-7588
Phone
(785) 587-4101
Fax
(785) 587-9090
NPI assigned
Nov 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1501273 KS Primary

Addresses

Primary practice location

4101 Anderson Ave
Manhattan, KS 66503-7588

Mailing address

4101 Anderson Ave
Manhattan, KS 66503-7588
Phone (785) 587-4101

Other practice location 1

930 Hayes Dr
Suite B
Manhattan, KS 66502-5721
Phone (785) 565-0016

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
I20101122000721 KS Practitioner - Physician Assistant 0941496533 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stonecreek Family Physicians, LLPGroup PAC ID 9335121565, 18 clinicians

Practice addresses (Care Compare)

4101 Anderson Ave
Manhattan, KS 66503-7588
Phone (785) 587-4101

Hospital & facility affiliations

National Provider Directory

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

Organizations & group practices 2

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": "1227225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1679728380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 ANDERSON AVE",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665037588",
            "telephone_number": "785-587-4101",
            "fax_number": "785-587-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 ANDERSON AVE",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665037588",
            "telephone_number": "785-587-4101",
            "fax_number": "785-587-9090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "930 Hayes Dr",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Manhattan",
            "state": "KS",
            "postal_code": "665025721",
            "country_code": "US",
            "telephone_number": "785-565-0016",
            "fax_number": "785-565-0003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEGNER-BUSCH",
        "first_name": "ELIZABETH",
        "middle_name": "KELLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KS",
            "license": "1501273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan, KS

Sources for this page

Verify at the official NPI Registry.