Individual provider Active NPI

Sariya Chayutipun

  • Acute Care Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1518435288
Registry record updated Dec 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95008624 Issued in CA
Practice address
2955 Veteran Ave
Los Angeles, CA 90064-9006
Phone
(310) 528-1340
NPI assigned
Nov 11, 2018
Last updated
Dec 1, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95008624 CA Primary

Addresses

Primary practice location

2955 Veteran Ave
Los Angeles, CA 90064-9006

Mailing address

2955 Veteran Ave
Los Angeles, CA 90064-4122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95008624CAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hany S. Aziz M.D., Inc CurrentSince Jul 24, 2019 Accepting new patients
St. John Critical Care Medical Group, Inc CurrentSince Jul 24, 2019 Accepting new patients

Locations

2615 Chester Ave
Bakersfield, CA 93301
Phone (661) 381-7545

3805 San Dimas St
Ste B
Bakersfield, CA 93301
Phone (661) 326-9999

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1541894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543622400000",
    "number": "1518435288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 VETERAN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900644122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 VETERAN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900649006",
            "telephone_number": "310-528-1340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAYUTIPUN",
        "first_name": "SARIYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-11",
        "last_updated": "2018-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95008624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.