Individual provider Active NPI

Narong Simakajornboon, MD

  • Pediatric Pulmonology Physician
  • Cincinnati, OH
National Provider Identifier
1083642565
Registry record updated Dec 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
88568 Issued in OH
Practice address
3333 Burnet Ave
MLC 2021
Cincinnati, OH 45229-3026
Phone
(513) 636-6771
NPI assigned
Jun 30, 2006
Last updated
Dec 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X MD.11827R LA
Pediatric Pulmonology Physician 2080P0214X 88568 OH Primary
Pediatric Sleep Medicine Physician 2080S0012X 88568 OH

Addresses

Primary practice location

3333 Burnet Ave
MLC 2021
Cincinnati, OH 45229-3026

Mailing address

3333 Burnet Ave
MLC 2021
Cincinnati, OH 45229-3026
Phone (513) 638-6771

Other identifiers 2

IdentifierTypeStateIssuer
1481840MedicaidLA
2695776MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20070116000258 OH Practitioner - Pediatric MedicinePractitioner - Pulmonary Disease 8527069632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Pulmonary Disease
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3333 Burnet Ave
Cincinnati, OH 45229-3026
Phone (513) 636-4200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.11827RLAMDPediatric Pulmonology Physician
88568OHMDPediatric Sleep Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Medical Center CurrentSince Sep 14, 2006 Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3333 Burnet Ave
#2021
Cincinnati, OH 45229
Phone (513) 636-6771

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354752000000",
    "number": "1083642565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "MLC 2021",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-638-6771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "MLC 2021",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-6771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMAKAJORNBOON",
        "first_name": "NARONG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2012-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "LA",
            "license": "MD.11827R",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "OH",
            "license": "88568",
            "primary": true
        },
        {
            "code": "2080S0012X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sleep Medicine",
            "state": "OH",
            "license": "88568",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1481840",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2695776",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.