Pat T Kouwabunpat, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A97918 Issued in CA

Practice address

1610 W Edinger Ave
Suite B
Santa Ana, CA 92704-4339

Phone

(714) 641-1610

Fax

(714) 641-1146

NPI assigned

May 7, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Family Practice

Education

Warren Alpert Medical School of Brown University, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: arpawong@direct.practicefusion.com

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

• P K a Medical Corporation

  • Primary Care Clinic/Center
  • Santa Ana, CA
  • NPI 1851537708
  Medicare reassignment NPD Authorized official
• South Coast Global Medical Center, Inc

  • General Acute Care Hospital
  • Santa Ana, CA
  • NPI 1558354258
  NPD (past)

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1063625069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 W EDINGER AVE",
            "address_2": "STE B",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927044339",
            "telephone_number": "714-641-1610",
            "fax_number": "714-641-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 W EDINGER AVE",
            "address_2": "SUITE B",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927044339",
            "telephone_number": "714-641-1610",
            "fax_number": "714-641-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUWABUNPAT",
        "first_name": "PAT",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A97918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A979180",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arpawong@direct.practicefusion.com",
            "affiliation": "N",
            "endpointDescription": "Practice Fusion EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1610 W Edinger Ave",
            "address_2": "Suite B",
            "city": "Santa Ana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927044339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karl Kottke
• Lisa Kou
• Lioudmila Koudrina, NP
• Somat Koung, MHS
• Krista Michelle Kousens, MSPA-C
• Marcy McMillin Kovacevich
• Kerri Kraft
• Witoon S Krailas, MD
• Kenneth B Krantz, MD
• Jennifer Renee Kraus

• Family Medicine Physician in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.