Individual provider Active NPI

Vasin Jungtrakoolchai, M.D.

  • Hospitalist Physician
  • Tamuning, GU
National Provider Identifier
1528398682
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
M-1691 Issued in GU
Practice address
999 S Marine Corps Dr
Unit 702
Tamuning, GU 96913-3415
Phone
(671) 977-5964
NPI assigned
Jan 12, 2010
Last updated
May 23, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2019

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 M-1691 GU
Geriatric Medicine (Internal Medicine) Physician 207RG0300X M-1691 GU
Hospitalist Physician 208M00000X M-1691 GU Primary

Addresses

Primary practice location

999 S Marine Corps Dr
Unit 702
Tamuning, GU 96913-3415

Mailing address

999 S Marine Corps Dr
Unit 702
Tamuning, GU 96913-3415
Phone (671) 977-5964

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
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
I20151211000544 GU Practitioner - Internal MedicinePractitioner - Geriatric Medicine 5193999134 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Med and NephrologyGroup PAC ID 1951296490, 14 clinicians
Guam Memorial HospitalGroup PAC ID 5890781694, 132 clinicians

Practice addresses (Care Compare)

736 Route 4
Suite 103
Sinajana, GU 96910-3368
Phone 6716497232201

850 Gov Carlos G Camacho Rd
Tamuning, GU 96913-3128
Phone (671) 647-2552

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
71.42 of 100Reported as group
Quality
34.49
Improvement activities
40
Cost
75.41

Merit-based Incentive Payment System (MIPS)

Final score
88.81 of 100Reported as group
Quality
83.57
Improvement activities
40
Cost
76.16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-1691GUMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Med & Nephrology CurrentSince Mar 15, 2024 Accepting new patients
Guam Memorial Hospital CurrentSince May 13, 2018 Accepting new patients
Guam Memorial Hospital CurrentSince May 13, 2018 Accepting new patients
Takecare Insurance Company Inc. Internal Medicine CurrentSince Oct 31, 2011 Accepting new patients
Advanced Eyecare, LLC PastSince Mar 15, 2024 Accepting new patients

Locations

736 Route 4
Ste 103
Sinajana, GU 96910
Phone (671) 649-7232

548 S Marine Corps Dr
Tamuning, GU 96913
Phone (671) 646-5824

850 Gov Carlos G Camacho Rd
Tamuning, GU 96913
Phone (671) 647-2555

850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552

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 1

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": "1263254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1528398682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 S MARINE CORPS DR",
            "address_2": "UNIT 702",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133415",
            "telephone_number": "671-977-5964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 S MARINE CORPS DR",
            "address_2": "UNIT 702",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133415",
            "telephone_number": "671-977-5964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNGTRAKOOLCHAI",
        "first_name": "VASIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-12",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GU",
            "license": "M-1691",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "GU",
            "license": "M-1691",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GU",
            "license": "M-1691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamuning, GU

Sources for this page

Verify at the official NPI Registry.