STHORN THATAYATIKOM (MD) – Pediatric Allergy/Immunology Physician, NPI 1134394596

STHORN THATAYATIKOM (MD) is a healthcare provider. based in Gainesville, Florida. specializing in Pediatric Allergy/Immunology Physician. They hold the professional credentials MD. They hold a License No. ME114556 (FL). The NPI Number for STHORN THATAYATIKOM (MD) is 1134394596

Main info

Female
Name
STHORN THATAYATIKOM (MD)
NPI
1134394596
Phone
(352) 294-5252
Address
1600 SW ARCHER RD
Enumeration Date
28 April 2008
Last Update Date
21 November 2023
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness75
Years active:18State licenses:1Digital endpointsOther names

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Provider Addresses for STHORN THATAYATIKOM (MD)

  • UF Health Shands Hospital, 1600, Archer Road, Gainesville, Alachua County, Florida, 32608, United States

    BOX 100371

    GAINESVILLE, FL 326100296

    Phone: (352) 294-5252

    Fax: (352) 294-8068

    Type: Location

  • 1600 SW Archer Rd

    Box 100371

    Gainesville, FL 326100296

    Phone: (352) 294-5252

    Fax: (352) 294-8068

    Type: Location

  • 191, Mill Street, Rockport, Knox County, Maine, 04856, United States

    PROVIDER ENROLLMENT

    ROCKLAND, DE 197320191

    Phone: (302) 651-6212

    Fax: (302) 651-4945

    Type: Mailing

  • 3000 N ORANGE AVE STE DE

    ORLANDO, FL 328047613

    Phone: (407) 845-8342

    Fax: (407) 845-8343

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $310.

Total Amount is formed as General ($310) + Research ($0) + Ownership ($0) = $310.

Last reported payment date: 2024-07-23 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($279).

Total Amount

$310

General + Research + Ownership

Payments

4

Total payment records

General Amount

$310

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-23

Latest reported date

Top Companies

Largest payers in this snapshot

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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: 2015-03-09

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
I20150309000379IAllergy/ImmunologyFLTBD

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

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

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 32610)

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Reviews

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Frequently asked questions

What is the standard ID for STHORN THATAYATIKOM (MD) in the U.S.?
In the U.S., STHORN THATAYATIKOM (MD) is identified by NPI 1134394596.
Quick check: is STHORN THATAYATIKOM (MD) active?
Public NPPES data shows STHORN THATAYATIKOM (MD) with an active NPI status right now.
What does the directory say STHORN THATAYATIKOM (MD) does?
Insurance directories may phrase it differently, but here STHORN THATAYATIKOM (MD) maps to Pediatric Allergy/Immunology Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to STHORN THATAYATIKOM (MD)?
STHORN THATAYATIKOM (MD) shows a connection to Gainesville, Florida in registry-derived data.
Why is information missing for STHORN THATAYATIKOM (MD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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