Siroj Dejhansathit, MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

ME170251 Issued in FL

Practice address

17190 SE 109TH Terrace Rd
Summerfield, FL 34491-9017

Phone

(352) 268-0003

NPI assigned

Jun 30, 2019

Sex

Male

Sole proprietor

No

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.

• Tricounty Health LLC

  • Internal Medicine Physician
  • Wildwood, FL
  • NPI 1619435179

  FL

  Medicare reassignment Care Compare group NPD

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

• Leesburg Regional Medical Center Inc

  • Urgent Care Clinic/Center
  • Leesburg, FL
  • NPI 1245001189

  Hospital

  Care Compare affiliation
• Leesburg Regional Medical Center Inc

  • General Acute Care Hospital
  • Leesburg, FL
  • NPI 1245226190

  Hospital

  Care Compare affiliation
• LRMC Urgent Care Center

  • Urgent Care Clinic/Center
  • Leesburg, FL
  • NPI 1598841389

  Hospital

  Care Compare affiliation
• Villages Tri-County Medical Center Inc.

  • General Acute Care Hospital
  • The Villages, FL
  • NPI 1740276518

  Hospital

  Care Compare affiliation

Specialty

Internal Medicine

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tricounty Health LLC 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Villages Regional Hospital, the Hospital, The Villages, FL, CCN 100290
• Uf Health Leesburg Hospital Hospital, Leesburg, FL, CCN 100084

Medicare fee-for-service enrollment

Enrolled in FL

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

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EDJGBD
• Direct secure messaging: sdejhansathit734873@direct.shands.ufl.edu

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 1, 2024.

{
    "created_epoch": "1561852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1215599261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6464 NE 118TH AVE",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321628633",
            "telephone_number": "806-224-3973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17190 SE 109TH TERRACE RD",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344919017",
            "telephone_number": "352-268-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJHANSATHIT",
        "first_name": "SIROJ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-30",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME170251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Ellis Davis, FNP
• Michelle Lynn Davis
• Mariana De Jongh-Beyer, MD
• Dahiana Eulalia De la Rosa Sanchez, APRN
• Deerfield Medical Supply Corp
• Fariborz Delbakhsh, M.D.
• Raymond Anthony Demascio, FNP, APRN-C
• Onsi N Derias, PT
• Divine Concepts Counseling Center
• Natalia Ivanovna Doroshina

• All providers in Summerfield, FL
• Endocrinology, Diabetes & Metabolism Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; 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.