NPIMap

Individual provider Active NPI

Tanit Phupitakphol, M.D.

  • Infectious Disease Physician
  • Brockton, MA
National Provider Identifier
1487005062
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
14235993-1205 Issued in UT
Practice address
130 Quincy Ave
Brockton, MA 02302-2803
Phone
(508) 941-7268
Fax
(508) 894-0412
NPI assigned
Jun 25, 2016
Last updated
Mar 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 286943 MA
Infectious Disease Physician 207RI0200X 286943 MA
Infectious Disease Physician 207RI0200X 14235993-1205 UT Primary

Addresses

Primary practice location

130 Quincy Ave
Brockton, MA 02302-2803

Mailing address

130 Quincy Ave
Brockton, MA 02302-2803
Phone (508) 941-7268

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tphupitakphol814424@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, UT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210702002467 MA Practitioner - Internal MedicinePractitioner - Infectious Disease 6305187519 Reassigns benefits to 1 organization
I20251118004851 UT Practitioner - Infectious Disease 6305187519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Infectious Disease
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

130 Quincy Ave
Brockton, MA 02302-2803
Phone (508) 941-7268

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 585-6387

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as group
Quality
70.13
Promoting interoperability
100
Improvement activities
40
Cost
75.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14235993-1205UTMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince Oct 4, 2025 Accepting new patients
Signature Healthcare Medical Group Inc Internal Medicine CurrentSince Aug 1, 2021 Accepting new patients
University of Utah Adult Services CurrentSince Oct 4, 2025 Accepting new patients
Brockton Hospital, Inc. PastSince Jun 1, 2021 Accepting new patients

Locations

130 Quincy Ave
Brockton, MA 02302
Phone (508) 941-7268

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Interoperability endpoints

  • Direct secure messaging: tanit.phupitakphol@direct.signature.masshiway.net
  • Direct secure messaging: tphupitakphol814424@direct.med.utah.edu

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 5

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": "1466812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1487005062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 QUINCY AVE",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022803",
            "telephone_number": "508-941-7268",
            "fax_number": "508-894-0412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 QUINCY AVE",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022803",
            "telephone_number": "508-941-7268",
            "fax_number": "508-894-0412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHUPITAKPHOL",
        "first_name": "TANIT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-25",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "286943",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MA",
            "license": "286943",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "UT",
            "license": "14235993-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tphupitakphol814424@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.