Tanusin Ploysangam, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

37142 Issued in IA

Practice address

1010 4TH St SW
Ste 330
Mason City, IA 50401-2857

Phone

(641) 424-0402

NPI assigned

Mar 29, 2007

Last updated

May 12, 2008By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• North Iowa Mercy Clinics

  dba Mercy Dermatology Clinic-Dr. Plank

  • Dermatology Physician
  • Mason City, IA
  • NPI 1619071834
  NPD (past)
• North Iowa Mercy Clinics

  dba MercyOne North Iowa Family and Sports Medicine

  • Sports Medicine (Family Medicine) Physician
  • Mason City, IA
  • NPI 1982300349
  NPD (past)

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1588783385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1894",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504021894",
            "telephone_number": "641-494-3041",
            "fax_number": "641-494-3059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 4TH ST SW",
            "address_2": "STE 330",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504012857",
            "telephone_number": "641-424-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOYSANGAM",
        "first_name": "TANUSIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IA",
            "license": "37142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA LICENSE",
            "identifier": "37142",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mahala Phillips, ARNP
• Abbey Pitzenberger, PHARM.D.
• Lyndsie Marie Pitzenberger, LMSW
• Carl J Plank, MD
• Brandon Plante, MD
• Michele Ann Plunkett, ARNP
• Polking & Polking, P.C.
• Robert James Polking, DDS
• Sorin Popescu, MD
• David William Popp, MD

• Dermatology Physician in Mason City, IA
• Providers in Mason City, IA by specialty
• Dermatology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.