Sukirti Bista, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2017-00991 Issued in NC

Practice address

2295 E 14TH St Ste 100
Winston Salem, NC 27105-6804

Phone

(336) 713-8860

Fax

(336) 713-8862

NPI assigned

Aug 20, 2011

Last updated

Nov 2, 2017By the provider in NPPES

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 NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  Medicare reassignment NPD

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

{
    "created_epoch": "1313798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509580800000",
    "number": "1629358742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602658",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602658",
            "telephone_number": "336-716-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 E 14TH ST STE 100",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271056804",
            "telephone_number": "336-713-8860",
            "fax_number": "336-713-8862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 Broad St",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Sumter",
            "state": "SC",
            "postal_code": "291504167",
            "country_code": "US",
            "telephone_number": "803-773-5227 x1015",
            "fax_number": "803-753-9312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BISTA",
        "first_name": "SUKIRTI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-20",
        "last_updated": "2017-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2017-00991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "385283",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "SC76947477",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicolas Ryan Bisig, D.M.D.
• Charlz Bisongebobetchu Bisong Jr., DO
• Kimberly Marie Biss, FNP-C
• Michael G Bissell, CPO, FAAOP
• Randall Glenn Bissette, MD
• Rosemary E Bisti, CRNA
• Margaret Bistok, PHARMD
• Rhonda L Bitting, M.D.
• Keela Bittle
• Erhan Biyikli

• Pediatrics Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.