Pidok Thepmankorn, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

25MA03010300 Issued in NJ

Practice address

495 N 13TH St
Newark, NJ 07107-1317

Phone

(973) 268-1400

NPI assigned

Sep 13, 2005

Last updated

Nov 9, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Emergency Associates of the North Ward, P.a.

  • Emergency Medicine Physician
  • Newark, NJ
  • NPI 1235130238
  NPD (past)
• Jersey City Medical Center

  • Emergency Medicine Physician
  • Jersey City, NJ
  • NPI 1053350421
  NPD (past)

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289260800000",
    "number": "1073508438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 W GILBERT STREET",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077014918",
            "telephone_number": "732-212-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 N 13TH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071071317",
            "telephone_number": "973-268-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEPMANKORN",
        "first_name": "PIDOK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2010-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA03010300",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NJ",
            "license": "25MA03010300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2378205",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Therapy Center at Wilson Towers
• The Ultimate Care Group
• The Wellness Center USA, LLC (The Wellness Center)
• The Yearns Organization, LLC (Family Truss)
• Belinda S Thelisma
• Therapy at Hand LLC
• Kelly Thibault, CRNP
• Chanelle Thom
• Dianne Theresa Thomas Kekovic, APN
• Devorah Thomas-James, L.C.S.W.

• Emergency Medicine Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Emergency Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.