Pornthep Wattanamano, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

L5950 Issued in TX

Practice address

3335 Riviera Dr
San Diego, CA 92109-6614

Phone

(713) 384-3229

NPI assigned

May 31, 2005

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 3

Medicare fee-for-service enrollment

Enrolled in CA

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

Internal Medicine

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Quantum Healthcare Medical Associates IncGroup PAC ID 5294647574, 109 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sutter Solano Medical Center Hospital, Vallejo, CA, CCN 050101

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 and National Provider Directory roles.

• Quantum Healthcare Medical Associates Inc.

  • Hospitalist Physician
  • Colton, CA
  • NPI 1568490597

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Northwest Infectious Disease and Travel Medicine, P.a.

  • Infectious Disease Physician
  • Houston, TX
  • NPI 1861496309
  NPD Authorized official
• Houston NW Id Specialists PA

  • Infectious Disease Physician
  • Houston, TX
  • NPI 1932468402
  NPD (past)

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

• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Vallejo, CA
  • NPI 1366686248
  Care Compare affiliation

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1295738516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3335 RIVIERA DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921096614",
            "telephone_number": "713-384-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3335 RIVIERA DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921096614",
            "telephone_number": "713-384-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTANAMANO",
        "first_name": "PORNTHEP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C186338",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "C186338",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "L5950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "157125902",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00193508",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8R0570",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy Gay Watson
• Teresa R Watson
• Angela Watt, LMFT
• Monique Watt
• Timothy Watt, M.D.
• Brooke Watte, BSN
• Lydia Watters
• Rachel Moriah Watters, PA-C, MPH, MHA
• Ashley E Watts, AU.D., CCC-A, CNIM
• Eli Marrette Watts, MD

• Infectious Disease Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Infectious Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.