Ashli J Benjamin, PA-C
Individual provider Active NPI Medical Physician Assistant · Derby, KS
NPI 1972583649 · NPPES record last updated Apr 25, 2025
Key facts
- NPI
- 1972583649
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 15-01056 (KS)
- Practice address
- 1640 E Tall Tree Rd
Derby, KS 67037-2000 - Phone
- (316) 274-8222
- Fax
- (316) 651-2344
- NPI assigned
- Jan 19, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051004000587 | KS | Practitioner - Physician Assistant | 1355376864 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00149 | KS | MD | Speech-Language Pathologist |
| 15-01056 | KS | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ascension Medical Group Via Christi, PA | Current |
Accepting new patients | |
| Ascension Medical Group Via Christi, PA | Current |
Accepting new patients | |
| Ascension Medical Group Via Christi, PA | Past | Accepting new patients |
Locations
308 E Central Ave
Andover, KS 67002
Phone (316) 262-4886
1640 E Tall Tree Rd
Derby, KS 67037
Phone (316) 274-8222
102 E Main St
Mulvane, KS 67110
Phone (316) 777-0106
14700 W Saint Teresa St
Ste 300
Wichita, KS 67235
Phone (316) 274-0142
3009 N Cypress St
Wichita, KS 67226
Phone (316) 261-3111
9211 E 21st St N
Wichita, KS 67206
Phone (316) 274-4501
8444 W 21st St N
Wichita, KS 67205
Phone (316) 274-9850
3311 E Murdock St
Wichita, KS 67208
Phone (316) 689-9107
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 15-01056 | KS | Yes |
Addresses
Primary practice location
1640 E Tall Tree Rd
Derby, KS 67037-2000
Mailing address
PO Box 8035
Wichita, KS 67208-0035
Phone (316) 689-9135
Other providers in Derby, KS
- Jeffrey R Battiste
- Mallory Lynn Baum
- Micheline Gerenda Bayliss
- Madelyn Rose Bean
- Elizabeth Belt
- Stacy Bible
- Madison Shelbi Bish
- Rachel Renee Blasi
- Breanna Bobbit
- Cody L Bobbit
All providers in Derby, KS · Medical Physician Assistant in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 25, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.