Individual provider Active NPI

Pensiri Sahatrungsinee

  • Physician Assistant
  • Pasadena, CA
National Provider Identifier
1093967747
Registry record updated Jul 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
100 W California Blvd
Unit 25
Pasadena, CA 91105-3010
Phone
(310) 795-4577
NPI assigned
Oct 14, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CA Primary

Addresses

Primary practice location

100 W California Blvd
Unit 25
Pasadena, CA 91105-3010

Mailing address

100 W California Blvd
Unit 25
Pasadena, CA 91105-3010
Phone (310) 795-4577

Other names 1

  • Penny Sahatrungsinee Other name

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130410000510 CA Practitioner - Physician Assistant 6800032194 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
20012CAMDAcupuncturist

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.

NPI Registry JSON

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

{
    "created_epoch": "1223942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343174400000",
    "number": "1093967747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W CALIFORNIA BLVD",
            "address_2": "UNIT 25",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053010",
            "telephone_number": "310-795-4577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W CALIFORNIA BLVD",
            "address_2": "UNIT 25",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053010",
            "telephone_number": "310-795-4577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAHATRUNGSINEE",
        "first_name": "PENSIRI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-14",
        "last_updated": "2012-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PENNY",
            "last_name": "SAHATRUNGSINEE",
            "credential": "P.A.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.