Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Sean-Carlo Prolago, PA

Individual provider Physician Assistant · NPI 1619057791

Sean-Carlo Prolago, PA is a Physician Assistant in Wichita, Kansas. Qualified in 1997, 29 years ago. Practices with Premier Phlebology, LLC, a 2-clinician group and accepts Medicare assignment. Licensed in Kansas.

Years since qualifying
29
Licensed in
KS
In the registry since
2006
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

4722 W Kellogg Dr
Wichita, KS 67209-2508
Phone: (316) 440-2565
Fax: (316) 440-2750
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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 15-00662 (KS)

Record details

NPI number1619057791
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 16, 2006
Last updated in NPPESMarch 30, 2021
Certification dateMarch 30, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice Premier Phlebology, Llc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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