Individual provider Active NPI

Pornchai Leelasinjaroen, M.D.

  • Gastroenterology Physician
  • Yakima, WA
National Provider Identifier
1336403062
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD60246817 Issued in WA
Practice address
3909 Creekside Loop Ste 120
Yakima, WA 98902
Phone
(509) 248-6616
Fax
(509) 225-2708
NPI assigned
Jun 27, 2012
Last updated
Jul 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301100064 MI
Gastroenterology Physician 207RG0100X MD60246817 WA Primary

Addresses

Primary practice location

3909 Creekside Loop Ste 120
Yakima, WA 98902

Mailing address

3800 Summitview Ave
Yakima, WA 98902-2715
Phone (509) 248-7849

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20180628002972 WA Practitioner - Gastroenterology 4385933902 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yakima Valley Memorial PhysiciansGroup PAC ID 1557391596, 397 clinicians

Practice addresses (Care Compare)

11027 Meridian Ave N
Suite 100
Seattle, WA 98133-1705
Phone (206) 365-4492

2811 Tieton Dr
Yakima, WA 98902-3761
Phone (509) 575-8000

7114 W Hood PL
Suite 433
Kennewick, WA 99336-6712
Phone (509) 734-4885

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy203
Upper gastrointestinal (GI) endoscopy for acid reflux170

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301100064MIMDInternal Medicine Physician
MD60246817WAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Memorial Physicians CurrentSince Sep 1, 2020 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Sep 1, 2020 Accepting new patients
Puget Sound Gastroenterology, PLLC Gastroenterology CurrentSince Oct 20, 2022 Accepting new patients
Puget Sound Gastroenterology, PLLC Gastroenterology CurrentSince Oct 20, 2022 Accepting new patients
Puget Sound Gastroenterology, PLLC Current Accepting new patients
Puget Sound Gastroenterology, PLLC Current Accepting new patients
Puget Sound Gastroenterology, PLLC Past Accepting new patients

Locations

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

7114 W Hood Pl
Kennewick, WA 99336
Phone (509) 734-4885

7114 W Hood Pl
#433
Kennewick, WA 99336
Phone (509) 734-4885

11800 NE 128th St
Ste 100
Kirkland, WA 98034
Phone (425) 899-4500

11027 Meridian Ave N
Ste 100
Seattle, WA 98133
Phone (206) 365-4492

2811 Tieton Dr
Yakima, WA 98902
Phone (509) 249-5210

3909 Creekside Loop
Ste 120
Yakima, WA 98902
Phone (509) 249-6616

Interoperability endpoints

  • Direct secure messaging: pleelasinjaroen774404@direct.multicare.org
  • Direct secure messaging: pornchai.leelasinjaroen@gastrohealth.eclinicaldirectplus.com

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1336403062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 SUMMITVIEW AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022715",
            "telephone_number": "509-248-7849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 CREEKSIDE LOOP STE 120",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "98902",
            "telephone_number": "509-248-6616",
            "fax_number": "509-225-2708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEELASINJAROEN",
        "first_name": "PORNCHAI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-27",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301100064",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "MD60246817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.