Tosaporn Krasaeath, MD
Individual provider Active NPI Diagnostic Radiology Physician · Vidalia, GA
NPI 1366424640 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1366424640
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 026884 (GA)
- Practice address
- 1703 Meadows LN
Vidalia, GA 30474-8915 - Phone
- (800) 382-4023
- NPI assigned
- Nov 14, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- Other, 1967
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Atlantic Radiology Associates LLC
Practice addresses (Care Compare)
4700 Waters Ave
Savannah, GA 31404-6283
Phone (912) 350-8436
Hospital & facility affiliations
- Memorial Health Meadows Hospital
- Effingham Health System
- Liberty Regional Medical Center
- Savannah Health Services LLC Dba Memorial Health University Medical Center
- Appling Healthcare
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100407000211 | GA | Practitioner - Diagnostic Radiology |
4880720416 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026884 | GA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Georgia Radiology Associates, LLC | Diagnostic Radiology | Current |
Accepting new patients |
| Atlantic Radiology Associates, LLC | Diagnostic Radiology | Current |
Accepting new patients |
| Bca Georgia, LLC | Current |
Accepting new patients | |
| Atlantic Radiology Associates, LLC | Diagnostic Radiology | Current |
Accepting new patients |
| Vidalia Radiology Associates | Diagnostic Radiology | Past | Accepting new patients |
Locations (25 of 76)
260 Mj Taylor Rd
Adel, GA 31620
Phone (229) 247-2290
172 Mj Taylor Rd
Adel, GA 31620
Phone (229) 896-3424
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) 537-3407
1500 E Shotwell St
Bainbridge, GA 39819
Phone (229) 243-6100
100 Highway 18 W
Barnesville, GA 30204
Phone (770) 358-0674
277 Lackawanna St
Baxley, GA 31513
Phone (912) 366-1362
950 S Main St
Ste 2
Baxley, GA 31513
Phone (912) 367-2596
163 E Tollison St
Baxley, GA 31513
Phone (912) 367-9847
35 Hospital Rd
Blairsville, GA 30512
Phone (706) 439-6812
19 Doctors Way
Ste A
Blairsville, GA 30512
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
901 Griffin Ave
Eastman, GA 31023
Phone (478) 374-4000
820 2nd Ave
Eastman, GA 31023
Phone (478) 374-5511
1120 Indian Dr
Eastman, GA 31023
Phone (478) 354-4220
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 026884 | GA | Yes |
Addresses
Primary practice location
1703 Meadows LN
Vidalia, GA 30474-8915
Mailing address
PO Box 2049
Moultrie, GA 31776-2049
Phone (800) 382-4023
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000292289C | Medicaid | GA |
Other providers in Vidalia, GA
- Kristen Keown
- Colleen Marie Kerrigan
- Rick L Kimbrel I
- Archie Thomas Kirkley
- Sarah B Kitchens
- Kimberly A Krupack
- Kurt P Hofmann MD LLC
- Mary Lesie Kyzer
- Jessica Leigh Langenfeld
- Lashonda Monique Lanier-Jenkins
All providers in Vidalia, GA · Diagnostic Radiology Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.