Individual provider Active NPI

Gregory Bryan De Laney, P.A.

  • Physician Assistant
  • Wichita, KS
National Provider Identifier
1962435552
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15-00622 Issued in KS
Practice address
1947 N Founders Cir
Wichita, KS 67206-3548
Phone
(316) 613-4707
Fax
(316) 613-5396
NPI assigned
Jul 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 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 15-00622 KS Primary

Addresses

Primary practice location

1947 N Founders Cir
Wichita, KS 67206-3548

Mailing address

1947 N Founders Cir
Wichita, KS 67206-3548
Phone (316) 613-4707

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
I20050510001200 KS Practitioner - Physician Assistant 3971543786 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00622KSMDBehavioral Analyst
15-00622KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Via Christi, PA CurrentSince Jul 13, 2020 Accepting new patients
Ascension Medical Group Via Christi, PA CurrentSince Jul 13, 2020 Accepting new patients
Pawnee Valley Community Hospital Inc Past Accepting new patients
Kansas Physicians Group, LLC Past Accepting new patients
Premonition Health LLC Physician Assistant PastSince May 1, 2024 Accepting new patients
Galichia Medical Group, P.a. Past Accepting new patients

Locations

1701 E 23rd Ave
Hutchinson, KS 67502
Phone (620) 665-2117

1947 N Founders Cir
Wichita, KS 67206
Phone (316) 613-4640

3311 E Murdock St
Wichita, KS 67208
Phone (316) 689-9107

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1962435552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1947 N FOUNDERS CIR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063548",
            "telephone_number": "316-613-4707",
            "fax_number": "316-613-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1947 N FOUNDERS CIR",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063548",
            "telephone_number": "316-613-4707",
            "fax_number": "316-613-5396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LANEY",
        "first_name": "GREGORY",
        "middle_name": "BRYAN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-00622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.