Sanga Bunyavanich, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

114997 Issued in NY

Practice address

6200 Beach Channel Dr
Arverne, NY 11692-1409

Phone

(718) 945-7150

Fax

(718) 663-6133

NPI assigned

Apr 21, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

State licenses

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

{
    "created_epoch": "1303344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361318400000",
    "number": "1992096259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 BEACH CHANNEL DR",
            "city": "ARVERNE",
            "state": "NY",
            "postal_code": "116921409",
            "telephone_number": "718-945-7150",
            "fax_number": "718-663-6133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 BEACH CHANNEL DR",
            "city": "ARVERNE",
            "state": "NY",
            "postal_code": "116921409",
            "telephone_number": "718-945-7150",
            "fax_number": "718-663-6133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNYAVANICH",
        "first_name": "SANGA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-21",
        "last_updated": "2013-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "114997",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "114997",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00816440",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oksana Bolson, N.P.
• Sasha Rashida Bowen
• Ebony Bryan
• Denise Pansy Bryant, LMSW
• Susana Dugang Bundoc, MD
• Sommai Bunyavanich, M.D.
• Ivana Ashley Burgos
• Sergelyne Benjamin Cadet-Valeus, M.D.
• Caren Lee, LCSW, PLLC
• Megan Anne Casper, RDN

• All providers in Arverne, NY
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; 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.