JUTHAMAS KOSITSAWAT
NPI 1104246016
Obstetrics & Gynecology in Loma Linda, CA
About Juthamas Kositsawat NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JUTHAMAS KOSITSAWAT (NPI 1104246016) is an individual obstetrics & gynecology provider in Loma Linda, California, licensed in California (A139735) and active in the NPI registry since April 2014. She is enrolled in Medicare PECOS, maintains a secondary practice location in Loma Linda, and is a graduate of Loma Linda University School Of Medicine (2014).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Juthamas Kositsawat is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Juthamas Kositsawat reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Loma Linda, CA 92354
- Reassigned Medicare billing, California enrollment
- 2,584 clinicians in this Medicare group
San Bernardino, CA 92408
- Reassigned Medicare billing, California enrollment
- 455 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92354 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LOMA LINDA, CA 92354
LOMA LINDA, CA 92354
LOMA LINDA, CA 92354
LOMA LINDA, CA 92354
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Juthamas Kositsawat's NPI number?
The NPI number for Juthamas Kositsawat is 1104246016. It was assigned to this individual provider in the NPPES registry on April 17, 2014.
Where is Juthamas Kositsawat located?
Juthamas Kositsawat practices at 11370 Anderson St, Loma Linda, CA 92354. The listed phone number is (909) 558-2806.
What is Juthamas Kositsawat's specialty?
The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.
Is Juthamas Kositsawat enrolled in Medicare?
Yes. Juthamas Kositsawat is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Juthamas Kositsawat's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Juthamas Kositsawat reassigns Medicare benefits to 2 organizations: Faculty Physicians And Surgeons Of Llusm (Loma Linda, CA) and Sac Health System (San Bernardino, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Juthamas Kositsawat's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Juthamas Kositsawat was last updated on September 24, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Juthamas Kositsawat · NPI 1104246016
Obstetrics & Gynecology physician in Loma Linda, California. Individual provider, active in the CMS NPPES registry since April 17, 2014.
## Identity
- **NPI:** 1104246016 (Entity type: Individual)
- **Enumerated:** April 17, 2014
- **Primary specialty:** Obstetrics & Gynecology · taxonomy 207V00000X
- **State license:** A139735 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 11370 ANDERSON ST, Loma Linda, CA 92354
- **Phone:** (909) 558-2806
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Faculty Physicians And Surgeons Of Llusm (NPI 1194775122, Loma Linda, CA); Sac Health System (NPI 1013935915, San Bernardino, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Loma Linda University School Of Medicine, class of 2014
## Record status
- **NPPES last updated:** September 24, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1104246016) · Data from the CMS NPPES public registry.