Individual provider Active NPI

Jirapat Teerakanok, MD

  • Rheumatology Physician
  • Worcester, MA
National Provider Identifier
1174906002
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
M2365 Issued in GU
Practice address
119 Belmont Street
Rheumatology
Worcester, MA 01605
Phone
(508) 334-5224
Fax
(508) 334-5654
NPI assigned
Jul 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Rheumatology Physician 207RR0500X M2365 GU Primary

Addresses

Primary practice location

119 Belmont Street
Rheumatology
Worcester, MA 01605

Mailing address

55 Lake Avenue North
Rheumatology
Worcester, MA 01655
Phone (508) 856-6246

Other practice location 1

3601 4th St
Ms 9410
Lubbock, TX 79430-0002
Phone (806) 743-3673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
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
I20230410000852 GU Practitioner - Rheumatology 5890084420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guam Healthcare Development IncorporatedGroup PAC ID 9234351776, 211 clinicians

Practice addresses (Care Compare)

133 Route 3
Dededo, GU 96929-6911
Phone (671) 645-5500

Hospital & facility affiliations

  • Guam Regional Medical City Hospital, Dededo, GU, CCN 650003

Merit-based Incentive Payment System (MIPS)

Final score
79.22 of 100Reported as group
Quality
78.84
Improvement activities
40
Cost
61.61

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M2365GUMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guam Healthcare Development Incorporated CurrentSince May 1, 2023 Accepting new patients

Locations

133 Route 3
Dededo, GU 96929
Phone (671) 645-5500

Interoperability endpoints

  • Direct secure messaging: jirapat.teerakarnok@direct.myteamcare.com

Organizations & group practices 1

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 1

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": "1436400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1174906002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 LAKE AVENUE NORTH",
            "address_2": "RHEUMATOLOGY",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01655",
            "telephone_number": "508-856-6246",
            "fax_number": "508-856-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 BELMONT STREET",
            "address_2": "RHEUMATOLOGY",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01605",
            "telephone_number": "508-334-5224",
            "fax_number": "508-334-5654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 4th St",
            "address_2": "MS 9410",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794300002",
            "country_code": "US",
            "telephone_number": "806-743-3673",
            "fax_number": "806-743-3560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEERAKANOK",
        "first_name": "JIRAPAT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-09",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "GU",
            "license": "M2365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.