Individual provider Active NPI

Chotikorn Khunnawat, M.D.

  • Cardiovascular Disease Physician
  • Poland, OH
National Provider Identifier
1245447879
Registry record updated Dec 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
35.132492 Issued in OH
Practice address
715 E Western Reserve Rd FL 2
Poland, OH 44514-3358
Phone
(330) 965-3363
Fax
(330) 729-7701
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35.132492 OH Primary

Addresses

Primary practice location

715 E Western Reserve Rd FL 2
Poland, OH 44514-3358

Mailing address

715 E Western Reserve Rd FL 2
Poland, OH 44514-3358
Phone (330) 965-3363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20180103003232 OH Practitioner - Cardiac Electrophysiology 0446518021 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Electrophysiology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

715 E Western Reserve Rd
FL 2
Poland, OH 44514-3358
Phone (330) 965-3363

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair49

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Youngstown, LLC Cardiovascular Disease Current Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC Cardiovascular Disease CurrentSince May 3, 2022 Accepting new patients
Mercy Health Physicians Youngstown Specialty Care LLC CurrentSince May 3, 2022 Accepting new patients
Mercy Health Physicians Youngstown LLC CurrentSince Jan 8, 2018 Accepting new patients

Locations

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

715 E Western Reserve Rd
Fl 2
Youngstown, OH 44514
Phone (330) 726-3204

250 E Federal St
Fl 4
Youngstown, OH 44503
Phone (330) 884-7010

Interoperability endpoints

  • Direct secure messaging: ckhunnawat365541@direct.bsmhealth.org

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.

Hospital & facility affiliations 5

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": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513641600000",
    "number": "1245447879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 E WESTERN RESERVE RD FL 2",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143358",
            "telephone_number": "330-965-3363",
            "fax_number": "330-729-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 E WESTERN RESERVE RD FL 2",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445143358",
            "telephone_number": "330-965-3363",
            "fax_number": "330-729-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHUNNAWAT",
        "first_name": "CHOTIKORN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2017-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35.132492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poland, OH

Sources for this page

Verify at the official NPI Registry.