Phudhiphorn Thienprasit, M.D., PH.D

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

21230 Issued in MN

Practice address

1675 Beam Ave
Ste 215
Maplewood, MN 55109-1172

Phone

(651) 748-1461

Fax

(651) 777-1191

NPI assigned

Jun 1, 2005

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

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.

• Millennium Neurosurgery, PA

  • Specialist
  • Maplewood, MN
  • NPI 1851314868
  NPD (past) Authorized official

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1437151669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 BEAM AVE",
            "address_2": "STE 215",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091172",
            "telephone_number": "651-748-1461",
            "fax_number": "651-777-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 BEAM AVE",
            "address_2": "STE 215",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091172",
            "telephone_number": "651-748-1461",
            "fax_number": "651-777-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIENPRASIT",
        "first_name": "PHUDHIPHORN",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MN",
            "license": "21230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Blessed Home Care LLC
• The Salvation Army (Lakewood Adult Day Center)
• Therapy Partners, Inc
• There's No Place Like Home Healthcare LLC
• Andre Robert Theuerkauf, MD
• Christopher Ronald Thole
• Anthony M Thomas
• Daniel Thomas, D.O.
• Tara Y Thomas, MD
• Kaitlin Ileen Thompson, RD

• Neurological Surgery Physician in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Neurological Surgery Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.