Chanika Phornphutkul, MD is a medicare enrolled "Medical Genetics - Clinical Biochemical Genetics" physician in Providence, Rhode Island. Her current practice location is
593 Eddy St, Providence, Rhode Island. You can reach out to her office (for appointments etc.) via phone at
(401) 444-8361.
Chanika Phornphutkul is licensed to practice in Rhode Island (license number MD10121) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1639124530.
Physician's Profile
| Full Name | Chanika Phornphutkul |
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| Gender | Female |
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| Speciality | |
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| Experience | Years |
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| Location | 593 Eddy St, Providence, Rhode Island |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Chanika Phornphutkul attended and graduated from in
NPI Data:
- NPI Number: 1639124530
- Provider Enumeration Date: 05/23/2006
- Last Update Date: 12/21/2011
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Chanika Phornphutkul such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1639124530 | NPI | - | NPPES |
| CP46587 | Medicaid | RI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2080P0205X | Pediatrics - Pediatric Endocrinology | 10121 (Rhode Island) | Secondary |
| 207SG0202X | Medical Genetics - Clinical Biochemical Genetics | MD10121 (Rhode Island) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Chanika Phornphutkul is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Chanika Phornphutkul, MD
593 Eddy St, Hasbro 122,
Providence, RI 02903-4923
Ph: (401) 444-8361 | Chanika Phornphutkul, MD
593 Eddy St,
Providence, RI 02903-4923
Ph: (401) 444-8361 |
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