Kunteera Tarin, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01064237A Issued in IN

Practice address

11275 Delaware Pkwy
Crown Point, IN 46307-7812

Phone

(219) 779-8735

Fax

(877) 715-2312

NPI assigned

Jul 30, 2009

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

Other names 1

• Kunteera Vachirasomboon Former name

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Internal MedicineAlso: Pediatric Medicine

Education

Indiana University School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Indiana Sports and Medical Science Institute, PCGroup PAC ID 2860662517, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Franciscan Health Crown Point Hospital, Crown Point, IN, CCN 150126

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
• Direct secure messaging: ktarin@isamsip-in.direct.office.nextgen.com

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.

• Indiana Sports & Medical Science Institute, PC

  • Clinic/Center
  • Crown Point, IN
  • NPI 1609155290
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Franciscan Health Crown Point

  • General Acute Care Hospital
  • Crown Point, IN
  • NPI 1336205798
  Care Compare affiliation

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1740411305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 108",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463080108",
            "telephone_number": "219-779-8735",
            "fax_number": "877-715-2312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11275 DELAWARE PKWY",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077812",
            "telephone_number": "219-779-8735",
            "fax_number": "877-715-2312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARIN",
        "first_name": "KUNTEERA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-30",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01064237A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200950380",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM TRADITIONAL",
            "identifier": "000000722745",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KUNTEERA",
            "last_name": "VACHIRASOMBOON",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kyle Swartz, PSYD, HSPP
• Reid Swenson
• Vanessa Lea Swida-Clarke, OTR
• Wajihuddin Syed
• Symphony of Crown Point LLC
• Alaina Tatum, PA-C
• Meredith Kammer Taylor, MA, CCC/SLP
• Sarah Taylor, NURSE PRACTITIONER
• Douglas A Tellinghuisen, DDS
• Kristine Teodori, DO

• Internal Medicine Physician in Crown Point, IN
• Providers in Crown Point, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.