Active NPI
Polakit Teekakirikul, M.D.
- Internal Medicine Physician
- Cambridge, MA
National Provider Identifier
1295099620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 252295
- Practice address
- 330 Mount Auburn St
Cambridge, MA 02138-5502 - Phone
- (617) 492-3500
- NPI assigned
- Jun 29, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Molecular Genetics Physician | 207SG0203X | CERTIFICATE #2011182 | MD | |
| Internal Medicine Physician | 207R00000X | 252295 | MA | Primary |
Addresses
Primary practice location
330 Mount Auburn St
Cambridge, MA 02138-5502
Mailing address
330 Mount Auburn St
Cambridge, MA 02138-5502
Phone (617) 492-3500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 252295 | MA | MD | Internal Medicine Physician |
| CERTIFICATE #2011182 | MD | MD | Clinical Molecular Genetics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401667200000",
"number": "1295099620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 MOUNT AUBURN ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021385502",
"telephone_number": "617-492-3500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 MOUNT AUBURN ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021385502",
"telephone_number": "617-492-3500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEEKAKIRIKUL",
"first_name": "POLAKIT",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-29",
"last_updated": "2014-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "207SG0203X",
"taxonomy_group": "",
"desc": "Medical Genetics, Clinical Molecular Genetics",
"state": "MD",
"license": "CERTIFICATE #2011182",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "252295",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.