Individual provider Active NPI

Kantima Phisitkul, MD

  • Nephrology Physician
  • Sioux City, IA
National Provider Identifier
1063604726
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
38776 Issued in IA
Practice address
2720 Stone Park Blvd
Sioux City, IA 51104-3734
Phone
(712) 279-3500
Fax
(712) 279-3640
NPI assigned
Aug 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 38776 IA
Student in an Organized Health Care Education/Training Program 390200000X BP1-0024170 TX
Nephrology Physician 207RN0300X 38776 IA Primary

Addresses

Primary practice location

2720 Stone Park Blvd
Sioux City, IA 51104-3734

Mailing address

2720 Stone Park Blvd
Sioux City, IA 51104-3734
Phone (712) 279-3500

Other practice location 1

601 Highway 6 W
Iowa City, IA 52246-2209
Phone (319) 338-0581

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100804000779 IA Practitioner - NephrologyPractitioner - Internal Medicine 8820121312 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siouxland Hospitalists PLLCGroup PAC ID 8123343803, 14 clinicians

Practice addresses (Care Compare)

2720 Stone Park Blvd
Sioux City, IA 51104-3734
Phone (712) 279-2303

Hospital & facility affiliations

  • St Lukes Regional Medical Center Hospital, Sioux City, IA, CCN 160146
  • Burgess Health Center Hospital, Onawa, IA, CCN 161359
  • Horn Memorial Hospital Hospital, Ida Grove, IA, CCN 161354
  • Floyd Valley Healthcare Hospital, Le Mars, IA, CCN 161368

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
38776IAMDInternal Medicine Physician
BP1-0024170TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation Internal Medicine CurrentSince Oct 1, 2025 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Siouxland Hospitalists PLLC Internal Medicine CurrentSince Apr 1, 2020 Accepting new patients
Northwest Iowa Hospital Corporation Past Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

2720 Stone Park Blvd
Ste 335
Sioux City, IA 51104
Phone (712) 220-6634

2720 Stone Park Blvd
Sioux City, IA 51104
Phone (712) 259-3000

801 5th St
Sioux City, IA 51101
Phone (712) 279-2010

Interoperability endpoints

  • Direct secure messaging: kphisitkul635462@direct.unitypoint.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1063604726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 STONE PARK BLVD",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511043734",
            "telephone_number": "712-279-3500",
            "fax_number": "712-279-3640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 STONE PARK BLVD",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511043734",
            "telephone_number": "712-279-3500",
            "fax_number": "712-279-3640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Highway 6 W",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522462209",
            "country_code": "US",
            "telephone_number": "319-338-0581",
            "fax_number": "319-887-4983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHISITKUL",
        "first_name": "KANTIMA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-15",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "38776",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP1-0024170",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IA",
            "license": "38776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

Verify at the official NPI Registry.