Ponrat Pakpreo, MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

MD00047151 Issued in WA

Practice address

16528 E Desmet CT Ste B-1000
Spokane Valley, WA 99216-3522

Phone

(509) 944-8860

Fax

(509) 944-8856

NPI assigned

Jun 12, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Providence Health & Services Washington

  dba Providence Medical Group SouthWest Washington

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1174744304
  Medicare reassignment NPD
• Providence Health & Services Washington

  dba Providence Medical Group

  • Pulmonary Disease Physician
  • Spokane, WA
  • NPI 1194099390
  Medicare reassignment NPD
• Providence Health & Services Washington

  dba Providence North East Washington Medical Group

  • Family Medicine Physician
  • Colville, WA
  • NPI 1083968879
  NPD
• Inland Empire Hospital Services Association

  dba Family Medicine of Spokane

  • Family Medicine Physician
  • Spokane, WA
  • NPI 1326002163
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1023050200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "509-893-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16528 E DESMET CT STE B-1000",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992163522",
            "telephone_number": "509-944-8860",
            "fax_number": "509-944-8856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAKPREO",
        "first_name": "PONRAT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "224294",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00047151",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NY",
            "license": "224294",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "WA",
            "license": "MD00047151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8468340",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02689641",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "AB32999",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyffani Page
• William T Page, MD
• Mark E.a. Paget, PTA,ATC,CSCS
• Pain Care Physicians PLLC
• Pain Care Physicians PLLC
• Ladeane Marie Palmar, LMP
• Allison W Palmer
• Chris Palmer, PA-C
• Telicia L Palmer
• Papa Tonys Enterprise (Elements Therapeutic Massage)

• Pediatric Adolescent Medicine Physician in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Pediatric Adolescent Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.