Mr Dittana Phoncharoensri, MD in Bermuda Run, NC

Mr Dittana Phoncharoensri, MD is a medicare enrolled "Psychiatry & Neurology - Sleep Medicine" physician in Bermuda Run, North Carolina. He graduated from medical school in 1997 and has 27 years of diverse experience with area of expertise as Neurology. He is a member of the group practice Novant Medical Group Inc and his current practice location is 152 E Kinderton Way Ste 101, Bermuda Run, North Carolina. You can reach out to his office (for appointments etc.) via phone at (336) 893-3180.

Mr Dittana Phoncharoensri is licensed to practice in North Carolina (license number 201300784) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1750585170.

Contact Information

	Mr Dittana Phoncharoensri, MD
	152 E Kinderton Way Ste 101, Bermuda Run, NC 27006-7351
	(336) 893-3180
	(336) 893-3189

Map and Direction

Physician's Profile

Full Name	Mr Dittana Phoncharoensri
Gender	Male
Speciality	Neurology
Experience	27 Years
Location	152 E Kinderton Way Ste 101, Bermuda Run, North Carolina
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mr Dittana Phoncharoensri graduated from medical school in 1997

NPI Data:

NPI Number: 1750585170
Provider Enumeration Date: 06/11/2007
Last Update Date: 10/25/2020

Medicare PECOS Information:

PECOS PAC ID: 1658411509
Enrollment ID: I20130719000434

Medical Identifiers

Medical identifiers for Mr Dittana Phoncharoensri such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1750585170	NPI	-	NPPES
1750585170	Medicaid	NC

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2084S0012X	Psychiatry & Neurology - Sleep Medicine	201300784 (North Carolina)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Novant Health Forsyth Medical Center	Winston-salem, NC	Hospital
Novant Health Medical Park Hospital	Winston-salem, NC	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Novant Medical Group Inc	1153234893	2023

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. Mr Dittana Phoncharoensri allows following entities to bill medicare on his behalf.

Entity Name	Novant Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366409492 PECOS PAC ID: 1153234893 Enrollment ID: O20031121000692

Entity Name	Novant Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1659571768 PECOS PAC ID: 1153234893 Enrollment ID: O20080207000174

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. Mr Dittana Phoncharoensri 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
Mr Dittana Phoncharoensri, MD Po Box 60447, Charlotte, NC 28260-0447 Ph: (336) 893-3180	Mr Dittana Phoncharoensri, MD 152 E Kinderton Way Ste 101, Bermuda Run, NC 27006-7351 Ph: (336) 893-3180

Mr Dittana Phoncharoensri, MD - Medicare Neurology in Bermuda Run, NC