NPIMap

Individual provider Active NPI

Konchok Norgais, M.D.

  • Internal Medicine Physician
  • East Lansing, MI
National Provider Identifier
1508219940
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301110637 Issued in MI
Practice address
804 Service Rd RM A225
East Lansing, MI 48824-7015
Phone
(517) 353-4941
Fax
(517) 432-3145
NPI assigned
Jul 21, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301110637 MI Primary

Addresses

Primary practice location

804 Service Rd RM A225
East Lansing, MI 48824-7015

Mailing address

788 Service Rd RM B301
East Lansing, MI 48824-7013
Phone (517) 353-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20190912001098 OR Practitioner - Internal Medicine 5890024012 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tuality Medical Group LLCGroup PAC ID 7416173414, 289 clinicians

Practice addresses (Care Compare)

335 SE 8TH Ave
Hillsboro, OR 97123-4246
Phone (503) 681-1111

Hospital & facility affiliations

  • Hillsboro Medical Center Hospital, Hillsboro, OR, CCN 380021
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301110637MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tuality Healthcare Current Accepting new patients
Tuality Healthcare CurrentSince Sep 1, 2019 Accepting new patients
Tuality Medical Group LLC CurrentSince Sep 1, 2019 Accepting new patients
Tuality Healthcare CurrentSince Sep 1, 2019 Accepting new patients
Tuality Medical Group LLC Internal Medicine CurrentSince Sep 1, 2019 Accepting new patients
Michigan State University Past Accepting new patients

Locations

335 SE 8th Ave
Hillsboro, OR 97123
Phone (503) 681-1111

Interoperability endpoints

  • Direct secure messaging: knorgais118365@direct.ohsu.edu

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1508219940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "788 SERVICE RD RM B301",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247013",
            "telephone_number": "517-353-5100",
            "fax_number": "517-432-2759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD RM A225",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-353-4941",
            "fax_number": "517-432-3145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORGAIS",
        "first_name": "KONCHOK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-21",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301110637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.