Individual provider Active NPI

Khanh Huynh, M.D.

  • Emergency Medicine Physician
  • Wichita, KS
National Provider Identifier
1790042067
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036136113 Issued in IL
Practice address
929 N Saint Francis St
Wichita, KS 67214-3821
Phone
(316) 268-5000
NPI assigned
Apr 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 04-37987 KS
Emergency Medicine Physician 207P00000X 01081835A IN
Emergency Medicine Physician 207P00000X 036136113 IL Primary

Addresses

Primary practice location

929 N Saint Francis St
Wichita, KS 67214-3821

Mailing address

3450 N Ridgewood St
Apt 418
Wichita, KS 67220-4416
Phone (312) 560-1731

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN, MN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20150430000364 IL Practitioner - Emergency Medicine 8224357983 Reassigns benefits to 2 organizations
I20190314000075 IN Practitioner - Emergency Medicine 8224357983 Reassigns benefits to 1 organization
I20220127002874 MN Practitioner - Emergency Medicine 8224357983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, 995 clinicians
Cepamerica Illinois LLPGroup PAC ID 3274793633, 492 clinicians

Practice addresses (Care Compare)

1606 N 7TH St
Terre Haute, IN 47804-2706
Phone (812) 238-7523

500 W Court St
Kankakee, IL 60901-3661
Phone (815) 937-2100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Emergency Medicine CurrentSince Mar 11, 2019 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Mar 1, 2017 Accepting new patients
Winona Health Services CurrentSince Dec 31, 2021 Accepting new patients
Vituity - Illinois Auc LLP Emergency Medicine Current Accepting new patients
Cepamerica Illinois LLP Emergency Medicine Current Accepting new patients
Vituity - Illinois Auc LLP Emergency Medicine CurrentSince Feb 1, 2019 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Mar 1, 2017 Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

600 S Randall Rd
Algonquin, IL 60102
Phone (224) 783-4300

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

1800 E Lake Shore Dr
Decatur, IL 62521
Phone (217) 464-2729

900 W Temple Ave
Bldg B
Effingham, IL 62401
Phone (217) 347-1690

801 W Temple Ave
Effingham, IL 62401
Phone (217) 342-5800

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

333 Madison St
Joliet, IL 60435
Phone (815) 725-7222

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

800 E Carpenter St
Springfield, IL 62702
Phone (217) 525-5643

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

855 Mankato Ave
Winona, MN 55987
Phone (507) 454-3680

Organizations & group practices 7

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 3

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": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1790042067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 N RIDGEWOOD ST",
            "address_2": "APT 418",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672204416",
            "telephone_number": "312-560-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 N SAINT FRANCIS ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143821",
            "telephone_number": "316-268-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYNH",
        "first_name": "KHANH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-11",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KS",
            "license": "04-37987",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01081835A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036136113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.