Individual provider Active NPI

Dusit Adstamongkonkul, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Tucson, AZ
National Provider Identifier
1619382645
Registry record updated Aug 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
81086 Issued in AZ
Practice address
2450 E River Rd
Tucson, AZ 85718-6522
Phone
(520) 795-7750
Fax
(520) 320-2155
NPI assigned
Jun 28, 2014
Last updated
Aug 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 7231 GA
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 2017039503 MO
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 81086 AZ Primary

Addresses

Primary practice location

2450 E River Rd
Tucson, AZ 85718-6522

Mailing address

2450 E River Rd
Tucson, AZ 85718-6522
Phone (520) 795-7750

Other practice location 1

780 Canton Rd NE Ste 400
Marietta, GA 30060-7298
Phone (770) 422-3602

Other practice location 2

1000 E Primrose St Ste 200
Springfield, MO 65807
Phone (417) 269-1010

Other practice location 3

3801 S National Ave Ste 130
Springfield, MO 65807-6162
Phone (417) 730-7160

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dadstamongkonkul530135@directwellstar.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, GA, MT3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20180710003239 MO Practitioner - Neurology 1951691617 Reassigns benefits to 2 organizations
I20230906003972 GA Practitioner - Neurology 1951691617 Reassigns benefits to 1 organization
I20241017004095 MT Practitioner - Neurology 1951691617 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

120 Stonebridge Pkwy
Woodstock, GA 30189-3768

145 N Medical Pkwy
Woodstock, GA 30189-7031
Phone (770) 592-3000

1510 Vernon Rd
Lagrange, GA 30240-4131
Phone (706) 845-3905

1514 Vernon Rd
Lagrange, GA 30240-4131
Phone (706) 880-7222

2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2068
Phone (770) 732-4022

2540 Windy Hill Rd
Marietta, GA 30067-8605
Phone (770) 644-1570

2540 Windy Hill Serd
Marietta, GA 30067-8605
Phone (770) 644-1274

2550 Windy Hill Rd SE
Suite 220
Marietta, GA 30067-8605
Phone (404) 321-9900

3000 Hospital Blvd
Roswell, GA 30076-4915
Phone (770) 751-2912

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 732-4022

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

601 S 8TH St
Griffin, GA 30224-4213
Phone (770) 228-2721

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

780 Canton Nerd
Suite 400
Marietta, GA 30060-7298
Phone (770) 422-3602

780 Canton Rd NE
Marietta, GA 30060-7298
Phone (770) 422-3602

8954 Hospital Dr
Douglasville, GA 30134-2272
Phone (678) 838-2585

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.59 of 100Reported as apm
Quality
92.87
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017039503MOMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SCL Health Medical Group - Billings, LLC CurrentSince Aug 11, 2024 Accepting new patients
SCL Health Montana CurrentSince Aug 11, 2024 Accepting new patients
SCL Health Medical Group - Billings LLC CurrentSince Aug 11, 2024 Accepting new patients
Cox-Monett Hospital, Inc. Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Sep 1, 2023 Accepting new patients
SCL Health Medical Group - Billings LLC Current Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
SCL Health Montana CurrentSince Aug 11, 2024 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

780 Canton Rd NE
Ste 400
Marietta, GA 30060
Phone (770) 422-3602

3801 S National Ave
Ste 130
Springfield, MO 65807
Phone (314) 273-0770

1041 N 29th St
Billings, MT 59101
Phone (303) 237-5577

1233 N 30th St
Billings, MT 59101
Phone (406) 237-3850

16 N Miles Ave
Hardin, MT 59034
Phone (406) 665-2205

Organizations & group practices 10

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 6

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": "1403913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787961600000",
    "number": "1619382645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 E RIVER RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857186522",
            "telephone_number": "520-795-7750",
            "fax_number": "520-320-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 E RIVER RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857186522",
            "telephone_number": "520-795-7750",
            "fax_number": "520-320-2155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "780 Canton Rd NE Ste 400",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300607298",
            "country_code": "US",
            "telephone_number": "770-422-3602",
            "fax_number": "770-421-6112",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 E Primrose St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "65807",
            "country_code": "US",
            "telephone_number": "417-269-1010",
            "fax_number": "417-269-6755",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3801 S National Ave Ste 130",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658076162",
            "country_code": "US",
            "telephone_number": "417-730-7160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADSTAMONGKONKUL",
        "first_name": "DUSIT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-28",
        "last_updated": "2026-08-29",
        "certification_date": "2026-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "GA",
            "license": "7231",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MO",
            "license": "2017039503",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "AZ",
            "license": "81086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dadstamongkonkul530135@directwellstar.org",
            "affiliation": "N",
            "address_1": "780 Canton Rd NE Ste 400",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300607298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.