Akaluck Thatayatikom, MD

Primary specialty

Pediatric Rheumatology PhysicianTaxonomy code 2080P0216X

License

ME114452 Issued in FL

Practice address

2501 N Orange Ave Ste 586
Orlando, FL 32804-4603

Phone

(407) 821-3545

Fax

(407) 821-3546

NPI assigned

May 21, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Pediatric Medicine

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: athatayatikom186865@adventhealth.direct-ci.com

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.

• Florida Hospital Medical Group Inc

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234
  Medicare reassignment Care Compare group NPD
• Florida Clinical Practice Association Inc

  • Surgery Physician
  • Gainesville, FL
  • NPI 1063463768
  Medicare reassignment NPD
• Florida Clinical Practice Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Ocala, FL
  • NPI 1609529478
  NPD
• Florida Hospital Medical Group Inc

  • Prosthetic/Orthotic Supplier
  • Minneola, FL
  • NPI 1285591545
  NPD

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1366650236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE STE 586",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044603",
            "telephone_number": "407-821-3545",
            "fax_number": "407-821-3546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE STE 586",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044603",
            "telephone_number": "407-821-3545",
            "fax_number": "407-821-3546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THATAYATIKOM",
        "first_name": "AKALUCK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "MO",
            "license": "2006035310",
            "primary": false
        },
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "FL",
            "license": "ME114452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007298300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Thalla
• Jina Kay Thalmann, LCSW
• Thomas Byron Thames, M.D.
• Sirin Thanasasavat, DMD
• Prakriti Thapa
• Sthorn Thatayatikom, MD
• Parmelee Thatcher, M.D.
• Grace Nicole Thayer, APRN
• THC & Co LLC
• The Accessible Acupuncture Initiative, Inc.

• Pediatric Rheumatology Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Pediatric Rheumatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; 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.