Sujittra Niyakorn, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01067615 Issued in IN

Practice address

4022 Hohman Ave
Hammond, IN 46327-1239

Phone

(219) 937-3300

Fax

(219) 931-0299

NPI assigned

May 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southlake Community Mental Health Center Inc.

  • Clinic/Center
  • Merrillville, IN
  • NPI 1821081290
  Medicare reassignment NPD
• Southlake Community Mental Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Hammond, IN
  • NPI 1609231927
  NPD
• Porter Physician Services LLC

  • Family Medicine Physician
  • Valparaiso, IN
  • NPI 1508075680
  NPD (past)

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1306067392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 S MICHIGAN AVE APT 3006",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053317",
            "telephone_number": "312-330-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4022 HOHMAN AVE",
            "city": "HAMMOND",
            "state": "IN",
            "postal_code": "463271239",
            "telephone_number": "219-937-3300",
            "fax_number": "219-931-0299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIYAKORN",
        "first_name": "SUJITTRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "6544",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01067615",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-132572",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• National Mentor Healtcare LLC
• NDR Home Care Service
• Jillian Nelson
• Nestlehut Hearing Center Inc.
• Ana Nevarez, PHARMD
• Latasha Norris
• Northshore Health Centers, Inc
• Northshore Health Centers, Inc
• Northwest Indiana Center for Family and Community Services Inc
• Northwest Indiana Community Action Corporation

• Family Medicine Physician in Hammond, IN
• Providers in Hammond, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; 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.