Khomthorn P Cunvong, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

3301 Matlock Rd
Arlington, TX 76015-2908

Phone

(682) 509-6200

NPI assigned

Jun 23, 2020

Last updated

Jun 23, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospital Medicine of Ak LLCGroup PAC ID 5395100598, 35 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Alaska Regional Hospital Hospital, Anchorage, AK, CCN 020017
• Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001
• Mat-Su Regional Medical Center Hospital, Palmer, AK, CCN 020006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: khomthorn.cunvong@hca7.eclinicaldirectplus.com

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 Medicine of Ak, LLC

  • Hospitalist Physician
  • Anchorage, AK
  • NPI 1346947470
  Medicare reassignment Care Compare group NPD
• Galen Hospital Alaska, Inc.

  dba Alaska Regional Hospital

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1952348047
  NPD (past)

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

• Galen Hospital Alaska, Inc.

  dba Alaska Regional Hospital

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1952348047
  Care Compare affiliation
• Mat-Su Valley Medical Center LLC

  dba Mat-Su Regional Medical Center

  • General Acute Care Hospital
  • Palmer, AK
  • NPI 1417975061
  Care Compare affiliation
• Providence Health & Services Washington

  dba Providence Alaska Medical Center

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1053363119
  Care Compare affiliation

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1396361580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 MATLOCK RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760152908",
            "telephone_number": "682-509-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 MATLOCK RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760152908",
            "telephone_number": "682-509-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNVONG",
        "first_name": "KHOMTHORN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Grace Cumberledge, RD, LD, CNSD
• Devin Austin Cummings, CCC-SLP
• Nhuuyen C Cung, DDS
• David Cunningham
• Makayla Cunningham
• Cuppett Psychology, PLLC
• Paul Richard Cuppett, PSYD
• Cure Allergy Clinic, PLLC
• Cure Partners, LLC (Cure Rx)
• Ajizhane Cureton

• Student in an Organized Health Care Education/Training Program in Arlington, TX
• Providers in Arlington, TX by specialty
• Student in an Organized Health Care Education/Training Program in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.