NPIMap

Individual provider Active NPI

Kraiyuth Vongxaiburana, M.D.

  • Neurology Physician
  • Gainesville, FL
National Provider Identifier
1447267000
Registry record updated Jul 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME92316 Issued in FL
Practice address
4343 West Newberry Rd
Gainesville, FL 32607-2817
Phone
(352) 224-2200
Fax
(352) 224-2484
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME92316 FL Primary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X ME92316 FL

Addresses

Primary practice location

4343 West Newberry Rd
Gainesville, FL 32607-2817

Mailing address

4881 NW 8TH Ave
Suite 2
Gainesville, FL 32605-4582
Phone (352) 373-6338

Other identifiers 13

IdentifierTypeStateIssuer
1065312OtherFLAETNA
1447267000OtherFLPHYSICIANS UNITED PLAN
15484901OtherFLCITRUS
593661648OtherFLUNIVERSAL HEALTH CARE
593661648OtherFLEVOLUTIONS
1487660247OtherFLMD MEDICARE CHOICE
29630OtherFLCOMP OPTIONS
304355OtherAVMED
29630OtherFLBC BS FL
P05944OtherFLFREEDOM HEALTH
2615237OtherFLUNITED HEALTH CARE
273660800MedicaidFL
P00438736OtherFLMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060103000271 FL Practitioner - NeuropsychiatryPractitioner - Neurology 3072535277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neuropsychiatry
Education
West Virginia University School of Medicine, 2000
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Simedhealth LLCGroup PAC ID 6608137054, 89 clinicians
Lake Area Physical Therapy Inc.Group PAC ID 3678604840, 372 clinicians

Practice addresses (Care Compare)

1315 NW 21St Ave
Chiefland, FL 32626-1977
Phone (352) 416-1082

4343 W Newberry Rd
Gainesville, FL 32607-2817
Phone (352) 416-1082

4881 NW 8TH Ave
Suite 2
Gainesville, FL 32605-4582
Phone (352) 416-1082

PO Box
Suite 1099
Melrose, FL 32666-1099

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83 of 100Reported as group
Quality
65.57
Promoting interoperability
99
Improvement activities
40
Cost
78.6

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Simedhealth LLC CurrentSince Apr 1, 2018 Accepting new patients
Simed Health LLC CurrentSince Apr 1, 2018 Accepting new patients
Saint Petersburg Neurology Clinic Neurology Past Accepting new patients
St. Anthony's Specialists LLC Past Accepting new patients

Locations

4343 Newberry Rd
Gainesville, FL 32607
Phone (352) 224-2200

4741 NW 8th Ave
Ste A
Gainesville, FL 32605
Phone (352) 374-9790

4881 NW 8th Ave
Ste 2
Gainesville, FL 32605
Phone (352) 373-6338

4343 Newberry Rd
Ste 3
Gainesville, FL 32607
Phone (352) 374-2222

3305 SW 34th Cir
Ste 101
Ocala, FL 34474
Phone (352) 373-4321

Interoperability endpoints

  • Direct secure messaging: kraiyuth.vongxaiburana@simedhealth.directbygreenway.com

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 11

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": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1447267000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 NW 8TH AVE",
            "address_2": "SUITE 2",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054582",
            "telephone_number": "352-373-6338",
            "fax_number": "352-373-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 WEST NEWBERRY RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072817",
            "telephone_number": "352-224-2200",
            "fax_number": "352-224-2484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONGXAIBURANA",
        "first_name": "KRAIYUTH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME92316",
            "primary": true
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "FL",
            "license": "ME92316",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1065312",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS UNITED PLAN",
            "identifier": "1447267000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CITRUS",
            "identifier": "15484901",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSAL HEALTH CARE",
            "identifier": "593661648",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVOLUTIONS",
            "identifier": "593661648",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD  MEDICARE CHOICE",
            "identifier": "1487660247",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMP OPTIONS",
            "identifier": "29630",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "304355",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS FL",
            "identifier": "29630",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREEDOM HEALTH",
            "identifier": "P05944",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2615237",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273660800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00438736",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.