Individual provider Active NPI

Jill N Makuka, PA

  • Physician Assistant
  • Wichita, KS
National Provider Identifier
1932500782
Registry record updated Jun 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1131 S Clifton Ave
Suite B
Wichita, KS 67218-2955
Phone
(316) 462-1040
Fax
(316) 462-1042
NPI assigned
Sep 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2017

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 Primary

Addresses

Primary practice location

1131 S Clifton Ave
Suite B
Wichita, KS 67218-2955

Mailing address

1131 S Clifton Ave
Suite B
Wichita, KS 67218-2955
Phone (316) 462-1040

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
I20141203001132 KS Practitioner - Physician Assistant 0547582496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2770 N Webb Rd
Wichita, KS 67226-8112
Phone (316) 630-4230

3333 N Webb Rd
Wichita, KS 67226-8123
Phone (316) 462-5000

9100 W 14TH St
Shawnee Mission, KS 66204-4004
Phone (913) 676-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Kansas PA CurrentSince Feb 23, 2015 Accepting new patients
Inpatient Consultants of Kansas PA CurrentSince Feb 23, 2015 Accepting new patients

Locations

10500 Quivira Rd
Shawnee Mission, KS 66215
Phone (913) 227-0565

9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230

1131 S Clifton Ave
Ste B
Wichita, KS 67218
Phone (316) 462-1040

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

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 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": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496880000000",
    "number": "1932500782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 S CLIFTON AVE",
            "address_2": "SUITE B",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672182955",
            "telephone_number": "316-462-1040",
            "fax_number": "316-462-1042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 S CLIFTON AVE",
            "address_2": "SUITE B",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672182955",
            "telephone_number": "316-462-1040",
            "fax_number": "316-462-1042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKUKA",
        "first_name": "JILL",
        "middle_name": "N",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-11",
        "last_updated": "2017-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.