Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Dr. David W Martell , DO

Dermatology โ€ข Manhattan, KS

Active NPI 1700147501 Individual Practitioner Male Practitioner Accepts Medicare assignment
Practice location in NPPES

4201 Anderson Ave Ste B2
Manhattan, KS 665037603

Call 7853207774 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

4201 Anderson Ave Ste B2

Manhattan, KS 665037603

Telephone 7853207774
Fax 7853207758
Organization at the Same NPPES Address or Phone
Kansas Medical Clinic Pa Facility NPI 1013051127

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 3 distinct additional practice-address records in Emporia, KS; Mission, KS; Monterey, CA. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

CMS Doctors and Clinicians lists 1 group name: Kansas Medical Clinic Pa. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2012

Medicare patients

1,080 people with Original Medicare in 2024

Different Original Medicare patients in 2024; counts below 11 are hidden; this does not show availability or quality.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider, 2024.

Medicare-allowed amount

About $413,674 in 2024

The total amount Medicare approved for these services in 2024. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.

What this does not show: Medicare-allowed amount

This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2024.

Paid by Medicare

About $298,681 in 2024

The part of the Medicare-allowed amount that Medicare itself paid in 2024, after patients' deductibles and coinsurance.

What this does not show: Paid by Medicare

This is not the clinician's income and not a measure of quality.

Source: CMS, Medicare Physician & Other Practitioners โ€“ by Provider and Service, 2024.

30-day fills

967 standardized 30-day fills in 2024

CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.

What this does not show: 30-day fills

It is not a count of patients and not a measure of quality.

Part D drug cost

$228,010 in 2024

The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.

What this does not show: Part D drug cost

A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.

Source: CMS, Medicare Part D Prescribers โ€“ by Provider and Drug, 2024.

Open Payments general payments, program year 2025

All general payments: $1,997.94 across 103 records.

By nature of payment

  • Food and Beverage: $1,902.06 across 102 records.
  • Long term medical supply or device loan: $95.88 across 1 record.

Reporting-company totals (3 largest of 18)

  • Janssen Pharmaceuticals, Inc: $405.70 across 22 records.
  • ABBVIE INC.: $240.97 across 15 records.
  • Bristol Myers Squibb Company: $210.10 across 12 records.

A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.

See the full table

Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2025 (published June 30, 2026).

Guide: How to read an Open Payments record

Years since graduation

14 years (graduated 2012)

CMS Doctors and Clinicians data list 2012 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2012

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, โ€œDoes your provider accept Medicare as full payment?โ€

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. Martell has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Martell as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Manhattan and Kansas

Billing and prescribing volume is not a quality rating.

Medicare Part B services

More Medicare Part B services than 65% of clinicians listed under Dermatology in Kansas (2024, 56 clinicians with data). Median for this group: 3,653. Middle half: 2,214 to 5,739.

Too few clinicians listed under Dermatology in Manhattan have Medicare Part B data for 2024 to compare.

Medicare-allowed amount

A higher Medicare-allowed amount than 70% of clinicians listed under Dermatology in Kansas (2024, 56 clinicians with data). Median for this group: $244,577. Middle half: $129,490 to $477,099.

Too few clinicians listed under Dermatology in Manhattan have Medicare Part B data for 2024 to compare.

Paid by Medicare

A higher Medicare payment amount than 70% of clinicians listed under Dermatology in Kansas (2024, 56 clinicians with data). Median for this group: $167,831. Middle half: $87,588 to $363,407.

Too few clinicians listed under Dermatology in Manhattan have Medicare Part B data for 2024 to compare.

Medicare Part D prescriptions

More Part D prescriptions than 60% of clinicians listed under Dermatology in Kansas (2024, 65 clinicians with data). Median for this group: 645. Middle half: 280 to 1,027.

Too few clinicians listed under Dermatology in Manhattan have Medicare Part D data for 2024 to compare.

Part D drug cost

A higher Part D drug cost than 70% of clinicians listed under Dermatology in Kansas (2024, 65 clinicians with data). Median for this group: $59,345. Middle half: $8,822 to $321,948.

Too few clinicians listed under Dermatology in Manhattan have Medicare Part D data for 2024 to compare.

3 active clinicians are listed under Dermatology with a practice address in Manhattan, KS (101 in Kansas).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Medicare Physician & Other Practitioners (2024), CMS Medicare Part D Prescribers (2024), CMS Open Payments (2025), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo ยท Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments ยท Program Year 2025
Disclosure Year:

Program year 2025 (payments made January 1 โ€“ December 31, 2025): 103 records totaling $1,997.94.

Manufacturer Payment Nature Product Type Amount ($)
Integra LifeSciences Corporation
Long term medical supply or device loan
In-kind items and services
Cytal General $95.88
Janssen Pharmaceuticals, Inc
Food and Beverage
In-kind items and services
TREMFYA General $72.24
Novartis Pharmaceuticals Corporation
Food and Beverage
In-kind items and services
Rhapsido General $48.75
Kerecis Limited
Food and Beverage
Cash or cash equivalent
Kerecis SurgiClose General $46.36
SUN PHARMACEUTICAL INDUSTRIES INC.
Food and Beverage
In-kind items and services
ILUMYA General $34.32
Incyte Corporation
Food and Beverage
Cash or cash equivalent
OPZELURA General $29.12
Regeneron Pharmaceuticals, Inc.
Food and Beverage
In-kind items and services
LIBTAYO General $28.26
Amgen Inc.
Food and Beverage
In-kind items and services
OTEZLA General $28.14
LEO Pharma Inc.
Food and Beverage
In-kind items and services
ANZUPGO General $26.25
LEO Pharma Inc.
Food and Beverage
In-kind items and services
ANZUPGO General $26.25
Bristol Myers Squibb Company
Food and Beverage
Cash or cash equivalent
Sotyktu General $25.22
UCB, Inc.
Food and Beverage
In-kind items and services
Bimzelx General $25.05
LEO Pharma Inc.
Food and Beverage
In-kind items and services
ADBRY General $24.95
Janssen Pharmaceuticals, Inc
Food and Beverage
In-kind items and services
TREMFYA General $23.41
Bristol Myers Squibb Company
Food and Beverage
Cash or cash equivalent
Sotyktu General $23.39
ABBVIE INC.
Food and Beverage
In-kind items and services
RINVOQ General $23.36
Bristol Myers Squibb Company
Food and Beverage
Cash or cash equivalent
Sotyktu General $23.27
Janssen Pharmaceuticals, Inc
Food and Beverage
In-kind items and services
TREMFYA General $23.20
Janssen Pharmaceuticals, Inc
Food and Beverage
In-kind items and services
TREMFYA General $22.54
LEO Pharma Inc.
Food and Beverage
In-kind items and services
ANZUPGO General $22.50
UCB, Inc.
Food and Beverage
In-kind items and services
Bimzelx General $22.32
Incyte Corporation
Food and Beverage
Cash or cash equivalent
OPZELURA General $21.85
Janssen Pharmaceuticals, Inc
Food and Beverage
In-kind items and services
TREMFYA General $21.66
Amgen Inc.
Food and Beverage
In-kind items and services
OTEZLA General $21.65
Janssen Pharmaceuticals, Inc
Food and Beverage
In-kind items and services
TREMFYA General $21.57

(top 25 shown)

Source: CMS Open Payments, program year 2025, released June 30, 2026.

Performed Procedures & Service Volume

Services billed to Original Medicare Part B in 2024.

CMS Part B ยท Data Year 2024
Reporting Year:

CPTยฎ is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2018โ€“2023 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners โ€“ by Provider and Service data, 2019โ€“2024; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

HCPCS Code Services Patients Submitted Charge Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths
1,158 279 $40.00 $6.05
99213 Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more
1,141 736 $150.00 $83.73
17000 Destruction of precancer skin growth, 1 growth
613 466 $200.00 $52.66
Q4158 Kerecis omega3, per square centimeter
422 16 $300.00 $154.71
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
363 363 $200.00 $102.24
11102 Biopsy of related skin growth, first growth
276 252 $275.00 $86.05
17110 Destruction of skin growth, 1-14 growths
185 158 $325.00 $101.76
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks
93 79 $1800.00 $554.57
11103 Biopsy of related skin growth, each additional growth
58 47 $125.00 $45.26
11104 Punch biopsy, first skin growth
54 52 $350.00 $111.97
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks
46 34 $1100.00 $347.42
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm
44 43 $1300.00 $243.55
17004 Destruction of precancer skin growth, 15 or more growths
42 36 $450.00 $149.93
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
40 32 $225.00 $118.30
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg
40 26 $22.50 $0.98
11105 Punch biopsy, each additional skin growth
38 37 $121.68 $53.81
96372 Injection of drug or substance under skin or into muscle
38 20 $45.00 $13.16
13121 Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm
34 33 $625.00 $316.90
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm
26 26 $650.00 $113.98
11900 Injection into skin growth, 1-7 growths
24 20 $100.00 $41.29
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
22 20 $115.00 $51.86
11200 Removal of skin tag, 1-15 skin tags
20 19 $150.00 $67.30
15275 Application of skin substitute graft to wound of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 25.0 sq cm or less of wound 100.0 sq cm or less
20 16 $350.00 $90.63
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm
18 18 $800.00 $259.50
13101 Complicated repair of wound of trunk, 2.6-7.5 cm
14 14 $725.00 $319.82

(top 25 shown)

Source: CMS Part B by Provider and Service, 2024; services under 11 beneficiaries omitted by CMS. Privacy limits

Submitted charges are billed amounts, not a price quote for your visit.

Medicare Part D Prescribing Profile & Medications

Medicare Part D prescriptions filled, including refills, in 2024.

CMS Part D ยท Data Year 2024
Prescription Year:
Brand Name Generic Name Prescriptions Day Supply Total Cost Patients
Ketoconazole Ketoconazole 105 3,116 $1,767.23 66
Clobetasol Propionate Clobetasol Propionate 83 2,220 $6,223.42 46
Triamcinolone Acetonide Triamcinolone Acetonide 80 1,623 $844.19 61
Doxycycline Hyclate Doxycycline Hyclate 64 1,901 $1,021.09 27
Tacrolimus Tacrolimus 54 1,215 $4,961.07 29
Dupixent Pen Dupilumab 52 1,428 $201,221.60 โ€”
Minoxidil Minoxidil 42 2,310 $405.63 15
Hydroxychloroquine Sulfate Hydroxychloroquine Sulfate 40 1,545 $822.80 โ€”
Terbinafine Hcl Terbinafine Hcl 38 921 $197.07 26
Hydrocortisone Hydrocortisone 37 834 $153.56 30
Fluorouracil Fluorouracil 32 711 $3,003.07 30
Methotrexate Methotrexate Sodium 31 1,447 $330.37 12
Prednisone Prednisone 24 548 $161.07 21
Metronidazole Metronidazole 24 688 $1,285.64 18
Betamethasone Dipropionate Betamethasone Dipropionate 24 587 $1,031.84 12
Fluconazole Fluconazole 21 296 $216.11 โ€”
Spironolactone Spironolactone 17 630 $304.04 โ€”
Clindamycin Phosphate Clindamycin Phosphate 16 474 $785.16 โ€”
Nystatin-Triamcinolone Nystatin/Triamcinolone Acet 14 227 $465.46 11
Ciclopirox Ciclopirox 13 359 $416.39 โ€”
Valacyclovir Valacyclovir Hcl 13 45 $102.86 โ€”
Fluocinolone Acetonide Fluocinolone/Shower Cap 13 326 $866.84 โ€”
Sulfamethoxazole-Trimethoprim Sulfamethoxazole/Trimethoprim 12 128 $47.90 12
Doxepin Hcl Doxepin Hcl 11 330 $93.98 โ€”
Acitretin Acitretin 11 330 $1,282.09 โ€”

Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-05-11
Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

License # reported to NPPES KS 05-41562

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Dermatology

NUCC Taxonomy Code: 207N00000X

License # reported to NPPES CA 20A22267

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Dermatology - MOHS-Micrographic Surgery

NUCC Taxonomy Code: 207ND0101X

License # reported to NPPES KS 05-41562

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

Dermatology - Procedural Dermatology

NUCC Taxonomy Code: 207NS0135X

License # reported to NPPES NE 1088

Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).

Dermatology - MOHS-Micrographic Surgery

NUCC Taxonomy Code: 207ND0101X

License # reported to NPPES CA 20A22267

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Kansas State Medical Licensing Board.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - DERMATOLOGY

Medicare Enrollment ID

I20260430003586

Enrollment State Jurisdiction

CA

PECOS Control ID

9234474990

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Kansas Medical Clinic Pa

4201 Anderson Ave, Manhattan, KS 665037603

Phone: 7853207774

Secondary Practice Locations

5820 Lamar Ave Ste 200

Mission, KS 662022655

Phone: 9136316330

9781 Blue Larkspur Ln

Monterey, CA 939406509

Phone: 8313339008

1602 W 15th Ave Ste D

Emporia, KS 668019804

Phone: 6202088518

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

2 listed
Dr. Majdy Albahhar , MD

Dermatology - MOHS-Micrographic Surgery

NPI 1013163211

Doctor of Medicine (M.D.)

Jessica Hubach , APRN

Nurse Practitioner - Family

NPI 1922715374

Advanced Practice Registered Nurse

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

14 Historical Events
๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 11, 2026

Dermatology (license number reported to NPPES: CA 20A22267)

๐Ÿ“
Updated Practice Location May 05, 2023

Registered at 4201 ANDERSON AVE STE B2, MANHATTAN, KS 665037603 (Tel: 7853207774)

๐Ÿ“
Updated Business Mailing Address May 05, 2023

Registered at 2200 SW 6TH AVE, TOPEKA, KS 666061707 (Tel: 7853548518)

๐Ÿ‘ค
Provider Name / Credentials Updated May 05, 2023

Recorded as DAVID MARTELL, DO

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 05, 2023

Dermatology (license number reported to NPPES: KS 05-41562)

๐Ÿ“
Updated Practice Location November 15, 2018

Registered at 650 HUEBNER RD, FT RILEY, KS 66442 (Tel: 7852397000)

๐Ÿ“
Updated Business Mailing Address November 15, 2018

Registered at 650 HUEBNER RD, FT RILEY, KS 664424030

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) November 15, 2018

Dermatology (license number reported to NPPES: NE 1088)

โœ…
NPI Profile Active June 07, 2012

NPI status registered as active in NPPES database

๐Ÿ“
Practice Location (Initial Record) June 07, 2012

Registered at 1 JARRETT WHITE RD, TRIPLER ARMY MEDICAL CENTER, TRIPLER AMC, HI 968595001 (Tel: 6235656097)

๐Ÿ“
Business Mailing Address (Initial Record) June 07, 2012

Registered at 1 JARRETT WHITE RD, TRIPLER ARMY MEDICAL CENTER, TRIPLER AMC, HI 968595001

๐Ÿ‘ค
Provider Name / Credentials (Initial Record) June 07, 2012

Recorded as DAVID MARTELL, D.O.

๐ŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 07, 2012

Student in an Organized Health Care Education/Training Program

๐ŸŸข
Initial NPI Registration & Enumeration June 07, 2012

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1700147501
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 07, 2012
Last Update: May 11, 2026
Sole Proprietor: No

Mailing Address

2200 Sw 6th Ave

Topeka, KS 666061707

Phone: 7853548518

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.