Active NPI
Sasithorn Chittchang, MD
- Pediatrics Physician
- Ellicott, MD
National Provider Identifier
1255759171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- D0016267
- Practice address
- 2338 Daniels Rd
Ellicott, MD 21043 - Phone
- (410) 461-9308
- NPI assigned
- Mar 29, 2014
- Last updated
- Mar 29, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | D0016267 | MD | Primary |
Addresses
Primary practice location
2338 Daniels Rd
Ellicott, MD 21043
Mailing address
2338 Daniels Rd
Ellicott, MD 21043
Phone (410) 461-9308
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00594 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0016267 | MD | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396051200000",
"number": "1255759171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2338 DANIELS RD",
"city": "ELLICOTT",
"state": "MD",
"postal_code": "21043",
"telephone_number": "410-461-9308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2338 DANIELS RD",
"city": "ELLICOTT",
"state": "MD",
"postal_code": "21043",
"telephone_number": "410-461-9308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHITTCHANG",
"first_name": "SASITHORN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-29",
"last_updated": "2014-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MD",
"license": "D0016267",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00594",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ellicott, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.