PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC
NPI 1972119741
General Practice in Leavenworth, KS
About Prime Healthcare Physician Services - Providence Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC (NPI 1972119741) is a healthcare organization registered as a general practice in Leavenworth, Kansas and active in the NPI registry since September 2020. The organization lists David Dulny, Providence Cfo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Prime Healthcare Physician Services - Providence Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
127Medicare enrollment records show 127 clinicians reassign Medicare billing to Prime Healthcare Physician Services - Providence Inc, which bills Medicare for the services they deliver. Of these, 7 practice at this address and 14 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 22
Nearest to this location (20)
See all 127Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Prime Healthcare Physician Services - Providence Inc's NPI number?
The NPI number for Prime Healthcare Physician Services - Providence Inc is 1972119741. It was assigned to this organization in the NPPES registry on September 17, 2020.
Where is Prime Healthcare Physician Services - Providence Inc located?
Prime Healthcare Physician Services - Providence Inc is located at 3550 S 4th St Ste 100, Leavenworth, KS 66048. The listed phone number is (913) 680-6200.
What is Prime Healthcare Physician Services - Providence Inc's specialty?
The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.
Is Prime Healthcare Physician Services - Providence Inc enrolled in Medicare?
Yes. Prime Healthcare Physician Services - Providence Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Prime Healthcare Physician Services - Providence Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 127 clinicians in 22 Medicare specialties reassign their Medicare billing to Prime Healthcare Physician Services - Providence Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (54), Family Practice (15) and Internal Medicine (14). Of these, 7 practice at this address and 14 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Prime Healthcare Physician Services - Providence Inc accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Sunflower Health Plan, Ambetter of Oklahoma and Anthem Blue Cross and Blue Shield and 1 other insurer list Prime Healthcare Physician Services - Providence Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Prime Healthcare Physician Services - Providence Inc was last updated on August 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Prime Healthcare Physician Services - Providence Inc · NPI 1972119741
General Practice organization in Leavenworth, Kansas. Organization record, active in the CMS NPPES registry since September 17, 2020.
## Identity
- **NPI:** 1972119741 (Entity type: Organization)
- **Enumerated:** September 17, 2020
- **Primary specialty:** General Practice · taxonomy 208D00000X
- **Organization subpart:** Yes (part of Prime Healthcare Physician Services - Providence Inc)
- **Authorized official:** David Dulny, PROVIDENCE CFO
## Practice location
- **Address:** 3550 S 4TH ST STE 100, Leavenworth, KS 66048-5061
- **Phone:** (913) 680-6200 · **Fax:** (913) 680-6348
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 127 clinicians in 22 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (54), Family Practice (15), Internal Medicine (14); 7 practice at this address and 14 within 10 miles; [full list](https://npiprofile.com/npi/1972119741/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 25, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1972119741) · Data from the CMS NPPES public registry.