Individual provider Active NPI

Pimpiroon Ploysangam

  • Ophthalmology Physician
  • Wilmington, DE
National Provider Identifier
1417310202
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
25MA12133900 Issued in NJ
Practice address
1600 Rockland Rd
Wilmington, DE 19803-3607
Phone
(856) 845-0100
Fax
(302) 651-5990
NPI assigned
Mar 30, 2016
Last updated
Jan 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 25MA12133900 NJ Primary

Addresses

Primary practice location

1600 Rockland Rd
Wilmington, DE 19803-3607

Mailing address

PO Box 191
Rockland, DE 19732-0191
Phone (302) 651-6718

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20210622003597 PA Practitioner - Ophthalmology 4183916562 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA12133900NJMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians CurrentSince Jul 1, 2021 Accepting new patients
University of Pittsburgh Physicians CurrentSince Jul 1, 2021 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients

Locations

203 Lothrop St
Fl 7
Pittsburgh, PA 15213
Phone (412) 647-2200

Interoperability endpoints

  • Direct secure messaging: pploysangam121461@direct.nemours.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1417310202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-6718",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ROCKLAND RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033607",
            "telephone_number": "856-845-0100",
            "fax_number": "302-651-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOYSANGAM",
        "first_name": "PIMPIROON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-30",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA12133900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.