Dr Nikom Udomphonkul, MD is a medicare enrolled "Internal Medicine" physician in Gridley, California. His current practice location is
284 Spruce St, Gridley, California. You can reach out to his office (for appointments etc.) via phone at
(530) 846-9035.
Dr Nikom Udomphonkul is licensed to practice in California (license number A34194) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1598849192.
Physician's Profile
| Full Name | Dr Nikom Udomphonkul |
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| Gender | Male |
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| Speciality | Internal Medicine |
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| Location | 284 Spruce St, Gridley, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1598849192
- Provider Enumeration Date: 10/24/2006
- Last Update Date: 02/23/2016
Medicare PECOS Information:
- PECOS PAC ID: 4082777529
- Enrollment ID: I20090921000287
Medical Identifiers
Medical identifiers for Dr Nikom Udomphonkul such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1598849192 | NPI | - | NPPES |
| 00A34194 | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207R00000X | Internal Medicine | A34194 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Nikom Udomphonkul allows following entities to bill medicare on his behalf.
| Entity Name | Orchard Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1477522019
PECOS PAC ID: 6800709049
Enrollment ID: O20031112000502 |
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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. Dr Nikom Udomphonkul 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 |
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Dr Nikom Udomphonkul, MD
Po Box 947,
Gridley, CA 95948
Ph: (530) 846-3604 | Dr Nikom Udomphonkul, MD
284 Spruce St,
Gridley, CA 95948-2216
Ph: (530) 846-9035 |
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