Individual provider Active NPI

Charurut Somboonwit, MD

  • Infectious Disease Physician
  • Tampa, FL
National Provider Identifier
1184612640
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
ME83811 Issued in FL
Practice address
1 Tampa General Cir # G318
Tampa, FL 33606-3571
Phone
(813) 844-4187
Fax
(813) 844-7605
NPI assigned
Oct 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X ME83811 FL Primary

Addresses

Primary practice location

1 Tampa General Cir # G318
Tampa, FL 33606-3571

Mailing address

PO Box 917770
Orlando, FL 32891-0001
Phone (813) 974-2201

Other identifiers 1

IdentifierTypeStateIssuer
265593400MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address csomboonwit8363@direct.tgh.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20050318000335 FL Practitioner - Infectious DiseasePractitioner - Internal Medicine 0345295747 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Department of HealthGroup PAC ID 3072424282, 126 clinicians
University Medical Service Association IncGroup PAC ID 6800790221, 818 clinicians

Practice addresses (Care Compare)

1105 E Kennedy Blvd
Hillsborough County Health Dep.
Tampa, FL 33602-3511
Phone 81330780156401

12901 Bruce B Downs Blvd
Tampa, FL 33612-4742
Phone (813) 821-8038

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone (813) 821-8038

2 Tampa General Cir
Tampa, FL 33606-3603
Phone (813) 821-8038

2 Tampa General Circle
4TH Floor
Tampa, FL 33606-3603
Phone (813) 821-8038

Hospital & facility affiliations

  • Tampa General Hospital Hospital, Tampa, FL, CCN 100128
  • H Lee Moffitt Cancer Center & Research Institute I Hospital, Tampa, FL, CCN 100271

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME83811FLMDInfectious Disease Physician

Practice roles (8 of 9)

OrganizationSpecialtyStatusNew patients
Florida Department of Health CurrentSince Aug 1, 2005 Accepting new patients
Tampa General Hospital Current Accepting new patients
University Medical Service Association Inc CurrentSince Jan 20, 2010 Accepting new patients
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer SCRN Ctr Inc Current Accepting new patients
Florida Department of Health CurrentSince Aug 1, 2005 Accepting new patients
University Medical Service Association Inc CurrentSince Jan 20, 2010 Accepting new patients
University Medical Service Association Inc Current Accepting new patients
Florida Department of Health PastSince Oct 1, 2000 Accepting new patients

Locations

1749 Holt Rd
Auburndale, FL 33823
Phone (863) 965-6259

12901 Bruce B Downs Blvd
#19
Tampa, FL 33612
Phone (813) 844-4103

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

2 Tampa General Cir
Fl 2
Tampa, FL 33606
Phone (813) 209-8596

8515 N Mitchell Ave
Tampa, FL 33604
Phone (813) 307-8047

1105 E Kennedy Blvd
Tampa, FL 33602
Phone (813) 307-8015

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: charurut.somboonwit@direct.moffitt.org
  • Direct secure messaging: csomboonwit8363@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 9

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": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1184612640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001",
            "telephone_number": "813-974-2201",
            "fax_number": "813-974-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TAMPA GENERAL CIR # G318",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063571",
            "telephone_number": "813-844-4187",
            "fax_number": "813-844-7605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMBOONWIT",
        "first_name": "CHARURUT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-10",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME83811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265593400",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csomboonwit8363@direct.tgh.org",
            "affiliation": "N",
            "address_1": "1 Tampa General Cir # G318",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.