Pongtawat Lertwilaiwittaya, MD

Primary specialty

Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X

License

47930 Issued in AL

Practice address

625 19TH St S
Birmingham, AL 35233-1900

Phone

(205) 934-9666

NPI assigned

Jun 23, 2021

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

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Medical Genetics and Genomics

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Alabama Health Services Foundation, PCGroup PAC ID 1951213107, 2,784 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Alabama Hospital Hospital, Birmingham, AL, CCN 010033

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 and National Provider Directory roles.

• University of Alabama Health Services Foundation, PC.

  • Multi-Specialty Clinic/Center
  • Birmingham, AL
  • NPI 1093768723
  Medicare reassignment Care Compare group NPD

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

• University of Alabama at Birmingham

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1154435824
  Care Compare affiliation
• University of Alabama at Birmingham

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1447145818
  Care Compare affiliation

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1619546751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331900",
            "telephone_number": "205-934-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LERTWILAIWITTAYA",
        "first_name": "PONGTAWAT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-23",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "AL",
            "license": "47930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vondra Leonard
• Tammy Leong, M.D.
• Connor Andrew Leopard, RN
• Naren Phillips Leopard, LCSW, PIP
• Morgan Lepard, MD
• Nicole Adele Leshoure, CPNP-PC
• Melissa Parrish Leslie, MD
• Jacob Lessing, M.D.
• Mary Kathleen Lessley, CRNA
• Michael Stuart Lessley, CRNA

• Clinical Genetics (M.D.) Physician in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Clinical Genetics (M.D.) Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; 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.