Individual provider Active NPI

Chayanin Musikasinthorn, MD

  • Surgery Physician
  • Gallup, NM
National Provider Identifier
1295930881
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD14862 Issued in HI
Practice address
516 East Nizhoni Blvd.
Gallup, NM 87301-1337
Phone
(505) 722-1000
Fax
(505) 722-1650
NPI assigned
Jun 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MDR5069 HI
Surgery Physician 208600000X MD14862 HI Primary

Addresses

Primary practice location

516 East Nizhoni Blvd.
Gallup, NM 87301-1337

Mailing address

P.O. Box 1337
Gallup, NM 87305-1337
Phone (505) 722-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, HI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20111011000559 TX Practitioner - General Surgery 6709058944 Reassigns benefits to 1 organization
I20151009001626 HI Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 6709058944 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
Uniformed Services Uhs Fe Hebert School of Med, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

1301 Punchbowl St
Honolulu, HI 96813-2499

1329 Lusitana St
Honolulu, HI 96813-2401

1380 Lusitana St
Honolulu, HI 96813-2448

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.05 of 100Reported as apm
Quality
89.81
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
78.18 of 100Reported as group
Quality
61.12
Improvement activities
40
Cost
81.87

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD14862HIMDSurgery Physician
MDR5069HIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Queens University Medical Group CurrentSince Apr 22, 2022 Accepting new patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Aug 15, 2011 Accepting new patients
The Queens Medical Center CurrentSince Sep 1, 2015 Accepting new patients
The Queen'S Medical Center CurrentSince Sep 1, 2015 Accepting new patients

Locations

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897

1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320192000000",
    "number": "1295930881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1337",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873051337",
            "telephone_number": "505-722-1000",
            "fax_number": "505-722-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 EAST NIZHONI BLVD.",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873011337",
            "telephone_number": "505-722-1000",
            "fax_number": "505-722-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSIKASINTHORN",
        "first_name": "CHAYANIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2011-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "HI",
            "license": "MDR5069",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "HI",
            "license": "MD14862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

Verify at the official NPI Registry.