Physician Compare National (NPI:1811054992)

HEALTHCARE PROVIDER: SANJAY G KHICHA MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1811054992
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6709986532
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070710000364
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KHICHA
	Individual professional last name
Provider First Name	SANJAY
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1999
	Individual professional's medical school graduation year
Primary Specialty	THORACIC SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	GENERAL SURGERY
	Second secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 3	VASCULAR SURGERY
	Third secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	CARDIOVASCULAR DISEASE (CARDIOLOGY), GENERAL SURGERY, VASCULAR SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	WICHITA SURGICAL SPECIALISTS PA
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	6507840634
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	46
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	9350 E 35TH N
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 103
	Group Practice or individual's line 2 address
City	WICHITA
	Group Practice or individual's city
State	KS
	Group Practice or individual's state
Zip Code	672262016
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3168585000
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	170123
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WESLEY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	170122
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	VIA CHRISTI HOSPITAL-WICHITA
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	170186
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	KANSAS HEART HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	170197
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	KANSAS MEDICAL CENTER LLC
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y