Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mary J Dagenais, PA

Individual provider Physician Assistant · NPI 1689666364

Mary J Dagenais, PA is a Physician Assistant in Wichita, Kansas. Qualified in 2002, 24 years ago. Practices with Midwest Physiatrists PA, a 2-clinician group and accepts Medicare assignment. Licensed in Kansas and Oklahoma.

Years since qualifying
24
Licensed in
KS, OK
In the registry since
2005
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

9415 E Harry St Ste 602
Wichita, KS 67207-5082
Phone: (316) 681-2420
Fax: (316) 681-3561
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 15-00874 (KS)
Physician Assistant Taxonomy 363A00000X · Licence 1218 (OK)

Record details

NPI number1689666364
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 18, 2005
Last updated in NPPESNovember 15, 2024
Certification dateNovember 15, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Midwest Physiatrists Pa — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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