Suneun Sarah Reichert, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

19660 Issued in CA

Practice address

593 W 6TH St
San Pedro, CA 90731-2521

Phone

(310) 547-0202

NPI assigned

Mar 19, 2014

Reactivated

Apr 24, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Suneun Sarah Kim Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ADEBAA

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.

• Harbor Community Clinic Inc.

  • Federally Qualified Health Center (FQHC)
  • San Pedro, CA
  • NPI 1467490425

  Case Manager/Care Coordinator

  Medicare reassignment NPD
• Harbor Community Clinic Inc

  • Pediatrics Physician
  • San Pedro, CA
  • NPI 1831739614
  NPD
• Hurtt Family Health Clinic Inc.

  • Federally Qualified Health Center (FQHC)
  • Anaheim, CA
  • NPI 1144760943
  NPD
• Hurtt Family Health Clinic Inc.

  • Federally Qualified Health Center (FQHC)
  • Tustin, CA
  • NPI 1306965587
  NPD
• Hurtt Family Health Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Santa Ana, CA
  • NPI 1003250093
  NPD (past)

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

{
    "created_epoch": "1395187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1083031769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 W 6TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 W 6TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312521",
            "telephone_number": "310-547-0202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "947 S Anaheim Blvd Ste 260",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928055591",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14642 Newport Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927806058",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100B N Tustin Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927053505",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Hope Dr",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927820221",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REICHERT",
        "first_name": "SUNEUN",
        "middle_name": "SARAH",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-19",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "deactivation_date": "2019-04-15",
        "reactivation_date": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "PTL1271",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "19660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUNEUN",
            "last_name": "KIM",
            "middle_name": "SARAH",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ramakrishna T.N. Reddy, M.D.
• Roopa Reddy, M.D.
• Usha Rani K. Reddy, M.D.
• Brent Reesha
• Christina Marie Reichert, NP
• Patrick David Reida, DC
• Alfred Remijio
• Gina Remington, R.N.
• Neil D Remington, M.D.
• Renew Integrated Program-2 Incorporation

• Family Medicine Physician in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.