Somsak Sittitavornwong, DDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

D5778 Issued in AL

Practice address

619 19TH Street South
Birmingham, AL 35233

Phone

(205) 934-4011

NPI assigned

May 16, 2006

Last updated

Feb 26, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Oral Surgery

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Alabama Health Services Foundation, PCGroup PAC ID 1951213107, 2,784 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Alabama Hospital Hospital, Birmingham, AL, CCN 010033

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ssittitavornwong@direct.uabmedicine.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University of Alabama at Birmingham

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1154435824
  Care Compare affiliation
• University of Alabama at Birmingham

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1447145818
  Care Compare affiliation

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1407808868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55310",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352555310",
            "telephone_number": "205-731-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 19TH STREET SOUTH",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35233",
            "telephone_number": "205-934-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SITTITAVORNWONG",
        "first_name": "SOMSAK",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AL",
            "license": "D5778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051542572",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009910986",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051542573",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051542567",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009910988",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009910983",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051542574",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009910984",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsi Sisk, CRNP
• Shawne M Sisk, M.ED., LMFT, NCC
• Sisson Counseling Services, LLC (Donna Sisson)
• Donna Sisson, LPC; LMFT
• Josie Sisson
• Kenia Situ
• Boopathy Sivaraman, PHARMD
• Soumya Sivaraman
• Melanie D Sivley, O.D.
• Krishmita Siwakoti

• Oral & Maxillofacial Surgery (D.M.D.) in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.