Vichit Vanadurongvan, MD is a medicare enrolled "General Practice" physician in Milbank, South Dakota. His current practice location is
803 E Milbank Ave, Milbank, South Dakota. You can reach out to his office (for appointments etc.) via phone at
(605) 432-4587.
Vichit Vanadurongvan is licensed to practice in South Dakota (license number 2310) 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 1649234428.
Physician's Profile
| Full Name | Vichit Vanadurongvan |
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| Gender | Male |
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| Speciality | General Practice |
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| Location | 803 E Milbank Ave, Milbank, South Dakota |
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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: 1649234428
- Provider Enumeration Date: 04/17/2006
- Last Update Date: 03/07/2023
Medicare PECOS Information:
- PECOS PAC ID: 1052376472
- Enrollment ID: I20041124000857
Medical Identifiers
Medical identifiers for Vichit Vanadurongvan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1649234428 | NPI | - | NPPES |
| 7300224 | Medicaid | SD | |
| 629363800 | Medicaid | MN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208D00000X | General Practice | 2310 (South Dakota) | 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. Vichit Vanadurongvan allows following entities to bill medicare on his behalf.
| Entity Name | Avera Mckennan |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1003389206
PECOS PAC ID: 0345157103
Enrollment ID: O20031110000117 |
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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. Vichit Vanadurongvan 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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Vichit Vanadurongvan, MD
13516 Sodak Rd,
Wilmot, SD 57279-8211
Ph: (605) 938-4574 | Vichit Vanadurongvan, MD
803 E Milbank Ave,
Milbank, SD 57252-1413
Ph: (605) 432-4587 |
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