DR. SARUNPORN (JAY) SIRIKIETSOONG (PSY.D.) – Psychologist, NPI 1871802314

DR. SARUNPORN (JAY) SIRIKIETSOONG (PSY.D.) is a healthcare provider. based in Springfield, Virginia. specializing in Psychologist. They hold the professional credentials PSY.D.. They hold a License No. 0810006183 (VA). The NPI Number for DR. SARUNPORN (JAY) SIRIKIETSOONG (PSY.D.) is 1871802314

Main info

Female
Sole Proprietor
8 Years Of Experience
Accepts Medicare Assignment
Name
DR. SARUNPORN (JAY) SIRIKIETSOONG (PSY.D.)
NPI
1871802314
Phone
(541) 514-9884
Address
6120 BRANDON AVE STE 315
Enumeration Date
1 October 2010
Last Update Date
5 June 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7033797350
Graduation Year
2018 (8 years ago)
PAC ID
6103254073
Group Practice PAC ID
2860484094
Professional Enrollment ID
I20200309001109
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:15State licenses:1Digital endpointsOther names

Provider Addresses for DR. SARUNPORN (JAY) SIRIKIETSOONG (PSY.D.)

  • 6120 BRANDON AVE STE 315

    SPRINGFIELD, VA 221502504

    Phone: (541) 514-9884

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-03-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200309001109IClinical PsychologistDCTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 22150)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2860484094View full group profile
NameSpecialtyState
Clinical PsychologistVA
Mental Health CounselorMO
Clinical PsychologistVA
Clinical PsychologistVA
Clinical PsychologistVA

Reviews

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Frequently asked questions

How is DR. SARUNPORN (JAY) SIRIKIETSOONG (PSY.D.) identified in CMS data?
CMS-hosted NPPES data lists DR. SARUNPORN (JAY) SIRIKIETSOONG (PSY.D.) with NPI 1871802314.
Does the file indicate DR. SARUNPORN (JAY) SIRIKIETSOONG (PSY.D.) is practicing under active NPI?
Directory data currently reports DR. SARUNPORN (JAY) SIRIKIETSOONG (PSY.D.) as active.
What is DR. SARUNPORN (JAY) SIRIKIETSOONG (PSY.D.)'s specialty?
The listing groups DR. SARUNPORN (JAY) SIRIKIETSOONG (PSY.D.) with Psychologist. Clinical services aligned with this taxonomy classification.
Where is DR. SARUNPORN (JAY) SIRIKIETSOONG (PSY.D.) based?
DR. SARUNPORN (JAY) SIRIKIETSOONG (PSY.D.) is tied to Springfield, Virginia in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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