Siam Sukumvanich, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

TRN14597 Issued in FL

Practice address

607 Herndon Pkwy Ste 101
Herndon, VA 20170-5477

Phone

(703) 471-0919

NPI assigned

Jun 22, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA, DC, MD3 enrollments

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 3

Specialty

Anesthesiology

Education

University of Oklahoma College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Capitol Anesthesia Associates LTDGroup PAC ID 3274848320, 17 clinicians

Practice addresses (Care Compare)

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.

• Capitol Anesthesia Associates, LTD

  • Anesthesiology Physician
  • Germantown, MD
  • NPI 1194106955

  DC, VA

  Medicare reassignment Care Compare group NPD
• Ambulatory Anesthesia Associates LLC

  • Anesthesiology Physician
  • Alexandria, VA
  • NPI 1720192230

  DC

  Medicare reassignment NPD
• Northstar Anesthesia of Virginia, LLC

  • Anesthesiology Physician
  • Alexandria, VA
  • NPI 1194488791

  DC

  Medicare reassignment NPD
• North American Partners in Anesthesia Maryland LLC

  • Anesthesiology Physician
  • Prince Frederick, MD
  • NPI 1093707879

  DC

  Medicare reassignment NPD
• Orthomed Staffing LLC

  • Anesthesiology Physician
  • Addison, TX
  • NPI 1225514276

  MD

  Medicare reassignment NPD

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1316174972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 HERNDON PKWY STE 101",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201705477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 HERNDON PKWY STE 101",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201705477",
            "telephone_number": "703-471-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUKUMVANICH",
        "first_name": "SIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-22",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "TRN14597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316174972",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Donna R Strait, P.T.
• Anne F Suazo, MSPT
• Aditi Subramanian, PT
• Sumayya Saleh Sulaiman
• Diane Hocker Sullivan, MS OTR/L
• Julia Cecile Sullivan, MT-BC
• Summit Speech-Language Therapy, LLC
• Sun Park DDS PC

• Anesthesiology Physician in Herndon, VA
• Providers in Herndon, VA by specialty
• Anesthesiology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.