Viengsouk Phommachanh, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

ME98812 Issued in FL

Practice address

2401 University Pkwy Ste 102
Sarasota, FL 34243-2894

Phone

(941) 355-2767

NPI assigned

Jun 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Otolaryngology

Education

Tulane University School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

ENT and Allergy Specialists of SWFL PAGroup PAC ID 6002009859, 3 clinicians

Vitalmd Group Holding LLCGroup PAC ID 8921091786, 535 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087
• Lakewood Ranch Medical Center Hospital, Bradenton, FL, CCN 100299
• Sarasota Memorial Hospital - Venice Hospital, North Venice, FL, CCN 100359

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vphommachanh@universityent.mdlogic.direct-ci.com

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.

• ENT & Allergy Specialists of SWFL PA

  • Otolaryngology Physician
  • Sarasota, FL
  • NPI 1417267600
  Medicare reassignment Care Compare group NPD
• Vitalmd Group Holding LLC

  • Obstetrics & Gynecology Physician
  • Miami, FL
  • NPI 1871572032
  Medicare reassignment Care Compare group NPD

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

• Lakewood Ranch Medical Center

  • General Acute Care Hospital
  • Bradenton, FL
  • NPI 1730179714
  Care Compare affiliation
• Sarasota County Public Hospital District

  • General Acute Care Hospital
  • North Venice, FL
  • NPI 1013534445
  Care Compare affiliation
• Sarasota County Public Hospital District

  • General Acute Care Hospital
  • Sarasota, FL
  • NPI 1245294826
  Care Compare affiliation

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

{
    "created_epoch": "1180828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1235331141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 UNIVERSITY PKWY STE 102",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432894",
            "telephone_number": "941-355-2767",
            "fax_number": "941-355-0617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 UNIVERSITY PKWY STE 102",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432894",
            "telephone_number": "941-355-2767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Nokomis Ave S",
            "address_purpose": "LOCATION",
            "city": "Venice",
            "state": "FL",
            "postal_code": "342852617",
            "country_code": "US",
            "telephone_number": "941-355-2767",
            "fax_number": "941-355-0617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHOMMACHANH",
        "first_name": "VIENGSOUK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-03",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME98812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002451300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "DI326Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Phillips, LCSW, MSSW
• Patti Phillips
• Yolanda Phillips
• Elisabeth Helen Phillipson, LCSW
• Allison Henley Phinney
• Physical Therapy of Sarasota
• Physicians Group
• Physicians Hearing Clinic LLC
• Physicians of South Florida, LLC
• Physio Med of Sarasota Inc

• Otolaryngology Physician in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Otolaryngology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; 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.

Verify at the official NPI Registry.