Kris Siriratsivawong, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

14967 Issued in ND

Practice address

34800 Bob Wilson Dr
San Diego, CA 92134-1098

Phone

(619) 532-7579

NPI assigned

Jan 27, 2007

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Acute Care Surgery Medical Group, Inc.

  • Surgery Physician
  • Sacramento, CA
  • NPI 1700069549
  Medicare reassignment NPD
• Kern County Hospital Authority

  • General Acute Care Hospital
  • Bakersfield, CA
  • NPI 1376623538
  Medicare reassignment NPD
• Surgical Affiliates of California

  • Surgery Physician
  • Los Banos, CA
  • NPI 1932440781
  Medicare reassignment NPD
• Anaheim Memorial Medical Center

  • General Acute Care Hospital
  • Anaheim, CA
  • NPI 1295782381
  NPD (past)
• Memorail Hospital of Los Banos

  • General Acute Care Hospital
  • Los Banos, CA
  • NPI 1154302271
  NPD (past)
• Coal Country Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Beulah, ND
  • NPI 1942288329
  NPD (past)

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

{
    "created_epoch": "1169856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520380800000",
    "number": "1205982592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 W CANYON AVE",
            "address_2": "APT 303",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234729",
            "telephone_number": "412-606-5166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341098",
            "telephone_number": "619-532-7579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRIRATSIVAWONG",
        "first_name": "KRIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-27",
        "last_updated": "2018-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ND",
            "license": "14967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Siraj
• Tammy Sirb, PTA
• Esmeralda Siria
• Skultip Sirikantraporn, PSY.D.
• Christopher P. Siriphand, MD
• Amy Sirkin
• Claude Sirlin
• Sirona Healing Center
• Kenneth Sirota
• Michael A Sirota, MD

• Surgery Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; 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.