Individual provider Active NPI

Patarapha Wongsaroj, M.D.

  • Nephrology Physician
  • Los Angeles, CA
National Provider Identifier
1174753784
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A119992 Issued in CA
Practice address
8635 W 3Rd St Ste 1195W
Los Angeles, CA 90048-6146
Phone
(310) 423-8663
NPI assigned
Jul 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 241226 MA
Nephrology Physician 207RN0300X A119992 CA Primary

Addresses

Primary practice location

8635 W 3Rd St Ste 1195W
Los Angeles, CA 90048-6146

Mailing address

829 S Le Doux Rd Apt 3
Los Angeles, CA 90035-1852
Phone (508) 615-2015

Other practice location 1

1530 Hillhurst Ave
Los Angeles, CA 90027-5516
Phone (323) 644-3880

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140805000000 CA Practitioner - NephrologyPractitioner - Internal Medicine 7012134778 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone (818) 653-4889

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
84.79
Promoting interoperability
99
Improvement activities
40
Cost
73.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
241226MAMDInternal Medicine Physician
A119992CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Patarapha Wongsaroj MD PC Nephrology CurrentSince May 8, 2024 Accepting new patients

Locations

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: pwongsaroj180706@direct.cshs.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1174753784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 S LE DOUX RD APT 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351852",
            "telephone_number": "508-615-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8635 W 3RD ST STE 1195W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900486146",
            "telephone_number": "310-423-8663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1530 Hillhurst Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900275516",
            "country_code": "US",
            "telephone_number": "323-644-3880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONGSAROJ",
        "first_name": "PATARAPHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-16",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "241226",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A119992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.