Porntip Kiatsimkul, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

MD222762 Issued in OR

Practice address

3640 NW Samaritan Dr Ste 210
Corvallis, OR 97330-3787

Phone

(541) 768-5810

NPI assigned

Jul 2, 2008

Last updated

May 2, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Good Samaritan Hospital Corvallis

  dba Samaritan Infectious Disease - Corvallis

  • Infectious Disease Physician
  • Corvallis, OR
  • NPI 1407112642
  NPD
• Good Samaritan Hospital Corvallis

  dba Samaritan Gynecologic Oncology - Corvallis

  • Gynecologic Oncology Physician
  • Corvallis, OR
  • NPI 1710787916
  NPD
• Good Samaritan Hospital Corvallis

  dba Good Samaritan Regional Medical Center

  • General Acute Care Hospital
  • Corvallis, OR
  • NPI 1962453134

  Single Specialty

  NPD
• Mid-Valley Healthcare Inc

  dba Samaritan Lebanon Community Hospital

  • Critical Access Hospital
  • Lebanon, OR
  • NPI 1689625980

  Single Specialty

  NPD
• Mid-Valley Healthcare Inc

  dba Samaritan Outpatient Treatment & Recovery Services - Newport

  • Addiction Medicine (Internal Medicine) Physician
  • Newport, OR
  • NPI 1740087899

  Single Specialty

  NPD
• Mid-Valley Healthcare, Inc.

  dba Main Street Family Medicine

  • Rural Health Clinic/Center
  • Lebanon, OR
  • NPI 1154687309
  NPD
• Samaritan Pacific Health Services, Inc

  dba Samaritan Kidney Specialists - Newport

  • Rural Health Clinic/Center
  • Depoe Bay, OR
  • NPI 1164781142
  NPD
• Samaritan Pacific Health Services, Inc

  dba Samaritan Pacific Communities Hospital

  • Critical Access Hospital
  • Newport, OR
  • NPI 1801847066
  NPD
• Samaritan Pacific Health Services, Inc.

  dba Samaritan Medical Group Occupational Medicine - Newport

  • Physical Medicine & Rehabilitation Physician
  • Newport, OR
  • NPI 1174888010

  Single Specialty

  NPD
• RCCH Trios Health LLC

  • Internal Medicine Physician
  • Kennewick, WA
  • NPI 1831682806

  Single Specialty

  NPD
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1205099082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973391189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 NW SAMARITAN DR STE 210",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303787",
            "telephone_number": "541-768-5810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 4th St",
            "address_2": "Stop 9410",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794300002",
            "country_code": "US",
            "telephone_number": "806-743-3155 x237",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "521 N Young St",
            "address_purpose": "LOCATION",
            "city": "Kennewick",
            "state": "WA",
            "postal_code": "99336",
            "country_code": "US",
            "telephone_number": "509-221-5980",
            "fax_number": "509-221-5897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIATSIMKUL",
        "first_name": "PORNTIP",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME132818",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "OR",
            "license": "MD222762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pkiatsimkul318733@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "3640 NW Samaritan Dr Ste 210",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973303787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erin Kettler
• Benjamin Daniel Kevan, ATC, PAC
• Nicole Keyser, MD
• Saira Khan, DPSYCH
• Ngoc Thanh Trang Khong
• Benjamin Washabaugh Kibler
• Rhonda Michele Kidney, LPC
• Christyna Kiesel
• Gweneth Joy Kieser
• Ruby Ellen Kiker, MPH, CPM, LDM

• Infectious Disease Physician in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Infectious Disease Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.