Individual provider Active NPI

Aunyaporn Amornpongchai, AU.D.

  • Audiologist
  • Stockton, CA
National Provider Identifier
1063799740
Registry record updated Jul 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2785 Issued in CA
Practice address
3601 Pacific Avenue
Audiology Department
Stockton, CA 95211
Phone
(209) 946-7378
NPI assigned
Nov 9, 2011
Last updated
Jul 25, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2785 CA Primary

Addresses

Primary practice location

3601 Pacific Avenue
Audiology Department
Stockton, CA 95211

Mailing address

3601 Pacific Avenue
Audiology Department
Stockton, CA 95211
Phone (209) 946-7378

Other names 1

  • Gail Amornpongchai Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111222000274 CA Practitioner - Qualified Audiologist 9032385182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of the PacificGroup PAC ID 2163740861, 10 clinicians

Practice addresses (Care Compare)

757 Brookside Rd
Stockton, CA 95211-0001
Phone (209) 946-7378

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2785CAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of the Pacific Current Accepting new patients
University of the Pacific CurrentSince Jun 1, 2017 Accepting new patients
University of the Pacific Audiologist CurrentSince Jun 1, 2017 Accepting new patients
University of the Pacific Past Accepting new patients

Locations

155 5th St
Ste 250
San Francisco, CA 94103
Phone (415) 780-2001

3601 Pacific Ave
Univ of the Pacific, CA 95211
Phone (209) 946-2132

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1063799740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 PACIFIC AVENUE",
            "address_2": "AUDIOLOGY DEPARTMENT",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95211",
            "telephone_number": "209-946-7378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 PACIFIC AVENUE",
            "address_2": "AUDIOLOGY DEPARTMENT",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95211",
            "telephone_number": "209-946-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMORNPONGCHAI",
        "first_name": "AUNYAPORN",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-09",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "2785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GAIL",
            "last_name": "AMORNPONGCHAI",
            "credential": "AU.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.