Pornchai Jonglertham, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

24180 Issued in NE

Practice address

815 N Kansas Ave
Hastings, NE 68901-4470

Phone

(402) 460-5899

Fax

(402) 460-5898

NPI assigned

Feb 22, 2007

Last updated

Sep 10, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in NE

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

Medical Oncology

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oncology Hematology West PCGroup PAC ID 8426030024, 56 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Jennie Edmundson Hospital, Council Bluffs, IA, CCN 160047
• CHI Health Bergan Mercy Hospital, Omaha, NE, CCN 280060
• Cass County Memorial Hospital Hospital, Atlantic, IA, CCN 161376
• Mary Lanning Healthcare Hospital, Hastings, NE, CCN 280032
• The Nebraska Methodist Hospital Hospital, Omaha, NE, CCN 280040

Procedures performed for Medicare patients

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.

• Oncology Hematology West, PC

  dba Nebraska Cancer Specialist

  • Hematology & Oncology Physician
  • Omaha, NE
  • NPI 1932178530
  Medicare reassignment Care Compare group NPD
• Oncology Hematology West, PC

  dba NCS Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Omaha, NE
  • NPI 1164833307
  NPD

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

• Alegent Health Bergan Mercy Health System

  dba Lasting Hope Recovery Center

  • Psychiatric Hospital Unit
  • Omaha, NE
  • NPI 1396969499
  Care Compare affiliation
• Alegent Health Bergan Mercy Health System

  dba CHI Health Creighton University Medical Center-Bergan Mercy

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1508941097
  Care Compare affiliation
• Nebraska Methodist Hospital

  dba Methodist Hospital

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1427147883
  Care Compare affiliation
• The Mary Lanning Memorial Hospital Association

  dba Mary Lanning Healthcare Laboratory Services

  • Clinical Medical Laboratory
  • Hastings, NE
  • NPI 1205442258

  Hospital

  Care Compare affiliation
• The Mary Lanning Memorial Hospital Association

  dba Mary Lanning Healthcare

  • Rural Acute Care Hospital
  • Hastings, NE
  • NPI 1831203488
  Care Compare affiliation
• Cass County Memorial Hospital

  • Critical Access Hospital
  • Atlantic, IA
  • NPI 1093760944
  Care Compare affiliation
• Jennie Edmundson Memorial Hospital

  dba Methodist Jennie Edmundson

  • General Acute Care Hospital
  • Council Bluffs, IA
  • NPI 1457448755
  Care Compare affiliation

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1265567242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 N KANSAS AVE",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689014470",
            "telephone_number": "402-460-5899",
            "fax_number": "402-460-5898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 N KANSAS AVE",
            "city": "HASTINGS",
            "state": "NE",
            "postal_code": "689014470",
            "telephone_number": "402-460-5899",
            "fax_number": "402-460-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONGLERTHAM",
        "first_name": "PORNCHAI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MS",
            "license": "15910",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TX",
            "license": "N0144",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NE",
            "license": "24180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS INDIVIDUAL NUMBER",
            "identifier": "00195",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195586603",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195586601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195586602",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P00436187",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "252609",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zipporah Marie Johnson
• Amber Jones
• Karen Jones, LPN
• Misti Leigh Jones
• Nancie Suzanne Jones
• Jessica Joppa
• Alexis Corinne Jordan
• Ashley Jean Josjor
• Gwendolyn Journey, APRN
• Wyndi Eve Jurgena

• Hematology & Oncology Physician in Hastings, NE
• Providers in Hastings, NE by specialty
• Hematology & Oncology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; 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.