Active NPI
Voottisin Michael Pisarnwongs, PA-C
- Physician Assistant
- Pasadena, CA
National Provider Identifier
1124739354
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA62297
- Practice address
- 10 Congress St Ste 210
Pasadena, CA 91105-3027 - Phone
- (626) 995-4447
- Fax
- (424) 314-0550
- NPI assigned
- Dec 8, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA62297 | CA | Primary |
Addresses
Primary practice location
10 Congress St Ste 210
Pasadena, CA 91105-3027
Mailing address
4140 W 190TH St
Torrance, CA 90504-5513
Other practice location 1
8255 Vineyard Ave Apt 1200G
Rancho Cucamonga, CA 91730-7183
Phone (818) 400-1417
Medicare participation
Medicare enrollment files- 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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
130 N Brand Blvd
Suite 204
Glendale, CA 91203-2617
Phone (818) 745-0070
130 N Brand Blvd
Suite 208
Glendale, CA 91203-2627
Phone (818) 945-6003
8635 W 3Rd St
Suite 465W
Los Angeles, CA 90048-6111
Phone (310) 423-0674
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.14 of 100
- Quality
- 84.79
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 73.15
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA62297 | CA | MD | Physician Assistant |
Interoperability endpoints
- mpisarnwongs446258@direct.cshs.org
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 and National Provider Directory roles.
-
dba The Mobile DRS
- Family Medicine Physician
- Glendale, CA
- NPI 1588439061
-
- Specialist
- Los Angeles, CA
- NPI 1316984388
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Huntington Hospital
- General Acute Care Hospital
- Pasadena, CA
- NPI 1407828429
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687996800000",
"number": "1124739354",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4140 W 190TH ST",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905045513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 CONGRESS ST STE 210",
"city": "PASADENA",
"state": "CA",
"postal_code": "911053027",
"telephone_number": "626-995-4447",
"fax_number": "424-314-0550"
}
],
"practiceLocations": [
{
"address_1": "8255 Vineyard Ave Apt 1200G",
"address_purpose": "LOCATION",
"city": "Rancho Cucamonga",
"state": "CA",
"postal_code": "917307183",
"country_code": "US",
"telephone_number": "818-400-1417",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PISARNWONGS",
"first_name": "VOOTTISIN",
"middle_name": "MICHAEL",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-12-08",
"last_updated": "2023-06-29",
"certification_date": "2023-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA62297",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.