Suttirak Chaiwongkarjohn

Primary specialty

SpecialistTaxonomy code 174400000X

License

A115809 Issued in CA

Practice address

45104 10TH St W
Lancaster, CA 93534-2310

Phone

(661) 942-2391

NPI assigned

Jul 20, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Infectious DiseaseAlso: General Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Antelope Valley Hospital Hospital, Lancaster, CA, CCN 050056

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: suttirak.chaiwongkarjohnmd.p1@direct.jwch.nextgenshare.com

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.

• Suttirak Chaiwongkarjohn, Inc.

  • Specialist
  • Valencia, CA
  • NPI 1396279105
  Medicare reassignment NPD Authorized official
• JWCH Institute Inc

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1407808058
  Medicare reassignment NPD
• JWCH Institute Inc

  • Federally Qualified Health Center (FQHC)
  • Lancaster, CA
  • NPI 1073209177
  NPD
• Tele-Medicine Services Ny, PLLC

  • Internal Medicine Physician
  • Roseville, CA
  • NPI 1609663780
  NPD (past)

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

• Antelope Valley Health Care District

  • General Acute Care Hospital
  • Lancaster, CA
  • NPI 1366419517
  Care Compare affiliation

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

{
    "created_epoch": "1216512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577750400000",
    "number": "1083879084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45104 10TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342310",
            "telephone_number": "661-942-2391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45104 10TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342310",
            "telephone_number": "661-942-2391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAIWONGKARJOHN",
        "first_name": "SUTTIRAK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-20",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A115809",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A115809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denika Chacon, LCSW 86269
• Nohemy Lwin Chacon
• David Chadorchi, PSY.D.
• Christopher Saul Chairez
• Chaitanya Lila Foster Family Home
• Challenger
• Challenger
• Challenger Memorial Youth Center
• Challenger Youth Memorial Center
• Kirin Ann Challman

• Specialist in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.