Individual provider Active NPI

Sussan Kokinda

  • Sleep Medicine (Internal Medicine) Physician
  • Redding, CA
National Provider Identifier
1780211516
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
License
24030 Issued in CA
Practice address
1505 Victor Ave
Redding, CA 96003-4031
Phone
(478) 751-0367
NPI assigned
Mar 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) Physician 207RS0012X 24030 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X GA

Addresses

Primary practice location

1505 Victor Ave
Redding, CA 96003-4031

Mailing address

1505 Victor Ave
Redding, CA 96003-4031
Phone (478) 751-0367

Other practice location 1

380 Hospital Dr Ste 430
Macon, GA 31217-8017
Phone (478) 751-0367

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20260601002431 CA Practitioner - Sleep MedicinePractitioner - Internal Medicine 2264902196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sleep MedicineAlso: Internal Medicine
Education
Philadelphia Col of Osteo Med, Sewanee, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

260 Lee St SW
Tumwater, WA 98501-4403

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1780211516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 VICTOR AVE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960034031",
            "telephone_number": "478-751-0367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 VICTOR AVE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960034031",
            "telephone_number": "478-751-0367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "380 Hospital Dr Ste 430",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312178017",
            "country_code": "US",
            "telephone_number": "478-751-0367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOKINDA",
        "first_name": "SUSSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-23",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "CA",
            "license": "24030",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.