Individual provider Active NPI

Sasithorn Ratanaprakarn Jitpakdee, M.D.

  • Family Medicine Physician
  • Santa Ana, CA
National Provider Identifier
1699871467
Registry record updated Mar 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A38940 Issued in CA
Practice address
2509 W McFadden Ave
Suite C
Santa Ana, CA 92704-2747
Phone
(714) 542-4724
Fax
(714) 542-4723
NPI assigned
Sep 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A38940 CA Primary
Pediatrics Physician 208000000X A38940 CA

Addresses

Primary practice location

2509 W McFadden Ave
Suite C
Santa Ana, CA 92704-2747

Mailing address

2509 W McFadden Ave
Suite C
Santa Ana, CA 92704-2747
Phone (714) 542-4724

Other identifiers 1

IdentifierTypeStateIssuer
00A389400MedicaidCA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A38940CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
P K a Medical Corporation Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268956800000",
    "number": "1699871467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 W MCFADDEN AVE",
            "address_2": "SUITE C",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927042747",
            "telephone_number": "714-542-4724",
            "fax_number": "714-542-4723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2509 W MCFADDEN AVE",
            "address_2": "SUITE C",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927042747",
            "telephone_number": "714-542-4724",
            "fax_number": "714-542-4723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JITPAKDEE",
        "first_name": "SASITHORN",
        "middle_name": "RATANAPRAKARN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2010-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A38940",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A38940",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A389400",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.