Peyapong Patanaphan, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

D0021797 Issued in MD

Practice address

200 E 33Rd St
Suite 631
Baltimore, MD 21218-3322

Phone

(410) 532-4848

Fax

(410) 554-4455

NPI assigned

Nov 13, 2006

Last updated

Apr 13, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Pat Tana Professional name

Medicare fee-for-service enrollment

Enrolled in MD

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

Specialty

Otolaryngology

Education

Other, 1971

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Maryland ENT Center LLCGroup PAC ID 4486712155, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

95.04

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Maryland ENT Center, LLC

  • Otolaryngology Physician
  • Baltimore, MD
  • NPI 1689690513
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460505600000",
    "number": "1578634242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ROLAND CT",
            "city": "RUXTON",
            "state": "MD",
            "postal_code": "212043550",
            "telephone_number": "410-337-8805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E 33RD ST",
            "address_2": "SUITE 631",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212183322",
            "telephone_number": "410-532-4848",
            "fax_number": "410-554-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATANAPHAN",
        "first_name": "PEYAPONG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2016-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D21797",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MD",
            "license": "D0021797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "979801300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAT",
            "last_name": "TANA",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Christian Pastora
• Marcos Pastora
• Jacquelynn Pastorino
• Anita Pasumarthy, M.D.
• Zane Adam Patalive, PA-C
• Siamrut Patanavanich
• Aneesh Gautam Patankar
• Patapsco Ave Health Services
• Michelle Patch, APRN-CNS
• Drew A Pate, M.D.

• Otolaryngology Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Otolaryngology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.