Individual provider Active NPI

Tanyatorn Ghanjanasak, D.O

  • Family Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1497060263
Registry record updated Mar 17, 2018
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128b(4) exclusion effective Aug 20, 2020.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
58.007764 Issued in OH
Practice address
6768 Chestnut St
Cincinnati, OH 45227-3607
Phone
(858) 255-9545
NPI assigned
Aug 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 902 NE
Family Medicine Physician 207Q00000X 58.007764 OH Primary

Addresses

Primary practice location

6768 Chestnut St
Cincinnati, OH 45227-3607

Mailing address

6768 Chestnut St
Cincinnati, OH 45227-3607
Phone (858) 255-9545

Other practice location 1

8900 Wisconsin Ave
Bethesda, MD 20889-0003
Phone (301) 295-4611

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
902NEMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1497060263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6768 CHESTNUT ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452273607",
            "telephone_number": "858-255-9545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6768 CHESTNUT ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452273607",
            "telephone_number": "858-255-9545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8900 Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208890003",
            "country_code": "US",
            "telephone_number": "301-295-4611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHANJANASAK",
        "first_name": "TANYATORN",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "902",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "58.007764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.