Individual provider Active NPI

Nontawan Benja-Athonsirikul

  • Obstetrics & Gynecology Physician
  • Nashville, TN
National Provider Identifier
1104243476
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
68873 Issued in TN
Practice address
330 23Rd Ave N Ste 604
Nashville, TN 37203-1534
Phone
(615) 986-6039
NPI assigned
Mar 25, 2014
Last updated
Nov 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 288951 NY
Obstetrics & Gynecology Physician 207V00000X 68873 TN Primary

Addresses

Primary practice location

330 23Rd Ave N Ste 604
Nashville, TN 37203-1534

Mailing address

3024 Business Park Cir
Goodlettsville, TN 37072-3132
Phone (615) 239-2018

Other practice location 1

343 E 30th St Lbby Level
New York, NY 10016
Phone (212) 725-2172

Other practice location 2

300 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210713003782 NY Practitioner - Obstetrics/Gynecology 2860894854 Reassigns benefits to 1 organization
I20230906002814 TN Practitioner - Obstetrics/Gynecology 2860894854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Diagnostic Imaging PCGroup PAC ID 7315848140, 523 clinicians

Practice addresses (Care Compare)

330 23Rd Ave N
Suite 604
Nashville, TN 37203-1534
Phone (615) 329-7940

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68873TNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Diagnostic Imaging, PC Obstetrics & Gynecology CurrentSince Aug 24, 2023 Accepting new patients
Rosh Maternal Fetal Medicine PLLC Obstetrics & Gynecology CurrentSince Feb 23, 2021 Accepting new patients
Advanced Diagnostic Imaging PC CurrentSince Aug 24, 2023 Accepting new patients
Judith Morris de Celis MD PC Obstetrics & Gynecology PastSince Aug 1, 2019 Accepting new patients

Locations

213 Madison Ave
Ste 1A
New York, NY 10016

343 E 30th St
Lbby
New York, NY 10016
Phone (212) 679-2213

3024 Business Park Cir
Goodlettsvlle, TN 37072
Phone (615) 239-2018

3443 Dickerson Pike
Ste 400
Nashville, TN 37207
Phone (615) 612-2146

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21664/brand/1/csg/1/fhir/r4
  • Direct secure messaging: nontawan.benjaathonsirikul@ahp.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1395705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1104243476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 BUSINESS PARK CIR",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370723132",
            "telephone_number": "615-239-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 23RD AVE N STE 604",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031534",
            "telephone_number": "615-986-6039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "343 E 30th St Lbby Level",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10016",
            "country_code": "US",
            "telephone_number": "212-725-2172",
            "fax_number": "212-683-8622",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Community Dr",
            "address_purpose": "LOCATION",
            "city": "Manhasset",
            "state": "NY",
            "postal_code": "110303816",
            "country_code": "US",
            "telephone_number": "516-562-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENJA-ATHONSIRIKUL",
        "first_name": "NONTAWAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-25",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "288951",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "68873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.