Angela Michelle Theobald, - Medicare Nurse Practitioner in Wichita, KS

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Angela Michelle Theobald, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Wichita, Kansas. Her current practice location is 1919 N Amidon Ave Ste 100, Wichita, Kansas. You can reach out to her office (for appointments etc.) via phone at (316) 866-2000.

Angela Michelle Theobald is licensed to practice in Kansas (license number 77752) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1427570373.

Contact Information

Angela Michelle Theobald,
1919 N Amidon Ave Ste 100,
Wichita, KS 67203-2118
(316) 866-2000
Not Available

Map and Direction




Provider's Profile

Full NameAngela Michelle Theobald
GenderFemale
SpecialityNurse Practitioner - Psychiatric/mental Health
Location1919 N Amidon Ave Ste 100, Wichita, Kansas
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1427570373
  • Provider Enumeration Date: 07/12/2017
  • Last Update Date: 10/16/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 6103196977
  • Enrollment ID: I20170727000415

Medical Identifiers

Medical identifiers for Angela Michelle Theobald such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1427570373NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 53-77752 (Kansas)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health 77752 (Kansas)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Angela Michelle Theobald allows following entities to bill medicare on her behalf.
Entity NameGracemed Health Clinic Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1184691693
PECOS PAC ID: 9830098185
Enrollment ID: O20040106000520
Entity NameSoma Recovery Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750850723
PECOS PAC ID: 7810387339
Enrollment ID: O20211123003204
Entity NameSoma Psychiatry Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1255166039
PECOS PAC ID: 2961937719
Enrollment ID: O20241203001719

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Angela Michelle Theobald is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Angela Michelle Theobald,
1122 N Topeka St,
Wichita, KS 67214-2810

Ph: (316) 866-2000		Angela Michelle Theobald,
1919 N Amidon Ave Ste 100,
Wichita, KS 67203-2118

Ph: (316) 866-2000

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.