Individual provider Active NPI

Tosaporn Krasaeath, MD

  • Diagnostic Radiology Physician
  • Vidalia, GA
National Provider Identifier
1366424640
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
026884 Issued in GA
Practice address
1703 Meadows LN
Vidalia, GA 30474-8915
Phone
(800) 382-4023
NPI assigned
Nov 14, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 026884 GA Primary

Addresses

Primary practice location

1703 Meadows LN
Vidalia, GA 30474-8915

Mailing address

PO Box 2049
Moultrie, GA 31776-2049
Phone (800) 382-4023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20100407000211 GA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 4880720416 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Other, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4700 Waters Ave
Savannah, GA 31404-6283
Phone (912) 350-8436

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
026884GAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Radiology Associates, LLC Diagnostic Radiology CurrentSince Jul 22, 2025 Accepting new patients
Atlantic Radiology Associates, LLC Diagnostic Radiology CurrentSince Jul 22, 2025 Accepting new patients
Bca Georgia, LLC CurrentSince Dec 1, 2022 Accepting new patients
South Georgia Radiology Associates, LLC Diagnostic Radiology CurrentSince Feb 1, 2010 Accepting new patients
Vidalia Radiology Associates Diagnostic Radiology Past Accepting new patients

Locations (25 of 75)

172 Mj Taylor Rd
Adel, GA 31620
Phone (229) 896-3424

260 Mj Taylor Rd
Adel, GA 31620
Phone (229) 247-2290

2822 Nottingham Way
Ste 3
Albany, GA 31707
Phone (229) 304-5261

302 S Wayne St
Alma, GA 31510
Phone (912) 632-8961

611 E Washington Ave
Ashburn, GA 31714
Phone (229) 353-2500

1500 E Shotwell St
Bainbridge, GA 39819
Phone (229) 243-6100

100 Highway 18 W
Barnesville, GA 30204
Phone (770) 358-0674

163 E Tollison St
Baxley, GA 31513
Phone (912) 367-9847

277 Lackawanna St
Baxley, GA 31513
Phone (912) 366-1362

950 S Main St
Ste 2
Baxley, GA 31513
Phone (912) 367-2596

19 Doctors Way
Ste A
Blairsville, GA 30512

35 Hospital Rd
Blairsville, GA 30512
Phone (706) 439-6812

630 Columbia St
Blakely, GA 39823
Phone (229) 723-4241

2855 Old Highway 5
Blue Ridge, GA 30513
Phone (706) 632-4263

209 N Cuthbert St
Colquitt, GA 39837
Phone (229) 758-3385

902 N 7th St
Cordele, GA 31015
Phone (229) 276-3100

541 441 Historic Hwy N
Demorest, GA 30535
Phone (706) 839-4000

200 Fairview Park Dr
Dublin, GA 31021
Phone (478) 272-6150

1120 Indian Dr
Eastman, GA 31023
Phone (478) 354-4220

820 2nd Ave
Eastman, GA 31023
Phone (478) 374-5511

901 Griffin Ave
Eastman, GA 31023
Phone (478) 374-4000

101 Lake Oconee Pkwy
Eatonton, GA 31024
Phone (706) 485-0907

4 Medical Dr
Elberton, GA 30635
Phone (706) 213-2527

200 Perry House Rd
Fitzgerald, GA 31750
Phone (229) 424-1461

88 Martin Luther King Jr Dr
Forsyth, GA 31029
Phone (419) 994-2521

Organizations & group practices 5

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 5

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": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366424640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2049",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317762049",
            "telephone_number": "800-382-4023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 MEADOWS LN",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748915",
            "telephone_number": "800-382-4023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASAEATH",
        "first_name": "TOSAPORN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "026884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vidalia, GA

Sources for this page

Verify at the official NPI Registry.