Kongkiet Thaera, M.D.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

01029739A Issued in IN

Practice address

901 Macarthur Blvd
Neonatology Department
Munster, IN 46321-2901

Phone

(219) 836-1600

NPI assigned

Apr 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Neonatology Associates, Inc

  • Neonatal-Perinatal Medicine Physician
  • Munster, IN
  • NPI 1528022860
  Authorized official Same address or phone

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679537914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 CALUMET AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212807",
            "telephone_number": "219-836-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MACARTHUR BLVD",
            "address_2": "NEONATOLOGY DEPARTMENT",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212901",
            "telephone_number": "219-836-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAERA",
        "first_name": "KONGKIET",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IN",
            "license": "01029739A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyanna Taylor
• Mariana Taylor, FNP-C
• Monica Ashley Teller, COTA/L
• Daria B Terrell, MD
• Terry Ebert, MD, Inc
• Jayesh Thakrar, M.D.
• Nicole Karin Thate
• The Dental Specialists Indiana PC
• The Dialysis Center of Munster LLC (Munster Dialysis Center)
• The Women's Wellness Center, P.C.

• Neonatal-Perinatal Medicine Physician in Munster, IN
• Providers in Munster, IN by specialty
• Neonatal-Perinatal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.