SAMPANTA BOONJARERN MD NPI 1073514642

NPI Information

NPI: 1073514642
Provider Name: SAMPANTA BOONJARERN, MD
Classification: Internal Medicine - 207RN0300X
Entity Type: Individual

Specialization: Nephrology

Address:
297 FRANCISCAN DR
CROWN POINT, IN
ZIP 46307
Phone: (219) 622-1718
Get Directions

Sampanta Boonjarern, MD is a nephrology internal medicine in Crown Point, IN. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. Sampanta Boonjarern, MD NPI is 1073514642. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

297 FRANCISCAN DR
CROWN POINT, IN
ZIP 46307-858
Phone: (219) 622-1718

The enumeration date for this NPI number is 8/9/2005 and was last updated on 10/5/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RN0300X	Internal Medicine	Nephrology	01027321A	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	622850B	MEDICARE PIN	INDIANA
2	CA5480	MEDICARE PIN	INDIANA
3	000000095595	OTHER	INDIANA	ANTHEM BCBS NUMBER
4	100082060	MEDICAID	INDIANA
5	628850	MEDICARE ID-TYPE UNSPECIFIED	INDIANA	GROUP MEDICARE NUMBER
6	E05578	MEDICARE UPIN	INDIANA
7	090001077	OTHER	ILLINOIS	IL BCBS NUMBER
8	100168430A	MEDICAID	INDIANA
9	390008281	MEDICARE PIN	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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