Sukanya Kanthawatana, MD

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

MD00037188 Issued in WA

Practice address

703 Lilly Rd NE
Suite 103
Olympia, WA 98506-5191

Phone

(360) 413-8760

Fax

(360) 413-8839

NPI assigned

Jul 28, 2005

Sex

Female

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 2

Medicare fee-for-service enrollment

Enrolled in WA

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

Merit-based Incentive Payment System (MIPS)

Final score

83.94 of 100Reported as group

Quality

77.83

Improvement activities

40

Cost

76.01

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: skanthawatana@daso.meditab.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.

• Dermatology & Allergy Specialists

  • Specialist
  • Olympia, WA
  • NPI 1497755797
  Medicare reassignment

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382400000000",
    "number": "1447250741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 W BAY DR NW",
            "address_2": "STE 301",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985024958",
            "telephone_number": "360-413-8760",
            "fax_number": "360-413-8839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 LILLY RD NE",
            "address_2": "SUITE 103",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065191",
            "telephone_number": "360-413-8760",
            "fax_number": "360-413-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANTHAWATANA",
        "first_name": "SUKANYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2013-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "WA",
            "license": "MD00037188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "GAB20352",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8240210",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Allergy & Immunology Physician in Olympia, WA
• Providers in Olympia, WA by specialty
• Allergy & Immunology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; 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.