LILY SOUDARATH SITISA
NPI 1336942697
Student in an Organized Health Care Education/Training Program in Chardon, OH

Q: What is Lily Sitisa's NPI number?

The NPI number for Lily Sitisa is 1336942697. It was assigned to this individual provider in the NPPES registry on March 31, 2025.

Q: What is Lily Sitisa's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Lily Sitisa was last updated on March 31, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 31, 2025PECOS Enrolled

13207 RAVENNA RD, CHARDON, OH 44024(585) 747-7846 Get Directions Write a Review

NPPES record last updated: March 31, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Lily Soudarath Sitisa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LILY SOUDARATH SITISA (NPI 1336942697) is an individual student in an organized health care education/training program in Chardon, Ohio and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336942697

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameLILY SOUDARATH SITISA

Location Address13207 RAVENNA RDChardon, OH 44024-7032

Mailing Address13207 Ravenna RdChardon, OH 44024-7032

Phone(585) 747-7846

Sole ProprietorNo

Enumeration DateMarch 31, 2025

NPPES CertifiedMarch 31, 2025

✔ NPI 1336942697 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

13207 RAVENNA RD, Chardon, OH 44024

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lily Soudarath Sitisa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.