Individual provider Active NPI

Sutikant Ratanachaiyaphan, LAC

  • Acupuncturist
  • Brooklyn, NY
National Provider Identifier
1467199604
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
005960 Issued in NY
Practice address
1 Hanson PL Ste 704
Brooklyn, NY 11243-2907
Phone
(718) 857-1900
Fax
(718) 857-1902
NPI assigned
May 18, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 005960 NY Primary

Addresses

Primary practice location

1 Hanson PL Ste 704
Brooklyn, NY 11243-2907

Mailing address

1255 5TH Ave - Suite 6L
New York, NY 10029-3996
Phone (914) 400-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
005960NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Health Sos PT PC CurrentSince Nov 5, 2023 Accepting new patients

Locations

1 Hanson Pl
Ste 704
Brooklyn, NY 11243
Phone (718) 857-1900

1255 5th Ave
Apt 6L
New York, NY 10029
Phone (914) 390-0080

139 E 57th St
New York, NY 10022
Phone (212) 753-4767

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1467199604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 5TH AVE - SUITE 6L",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100293996",
            "telephone_number": "914-400-1500",
            "fax_number": "914-478-8781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HANSON PL STE 704",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112432907",
            "telephone_number": "718-857-1900",
            "fax_number": "718-857-1902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATANACHAIYAPHAN",
        "first_name": "SUTIKANT",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-18",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "005960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.