Active NPI
Tanyatorn Ghanjanasak, D.O
- Family Medicine Physician
- Cincinnati, OH
National Provider Identifier
1497060263
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.
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 58.007764
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 902 | NE | MD | Addiction (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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.