Individual provider Active NPI

Marut K Thongcharoen

  • Internal Medicine Physician
  • San Leandro, CA
National Provider Identifier
1710132980
Registry record updated Apr 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C00141591 Issued in CA
Practice address
2800 Benedict Dr
San Leandro, CA 94577-6840
Phone
(510) 357-8300
Fax
(510) 620-3924
NPI assigned
Dec 1, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 251033 NY
Internal Medicine Physician 207R00000X C00141591 CA Primary

Addresses

Primary practice location

2800 Benedict Dr
San Leandro, CA 94577-6840

Mailing address

5870 N Hiatus Rd
Regional Admin Office
Tamarac, FL 33321-6424
Phone (888) 447-2362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20101115000176 NY Practitioner - Internal Medicine 0244425361 Reassigns benefits to 1 organization
I20190510000660 CA Practitioner - Internal Medicine 0244425361 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Inpatient Medical GroupGroup PAC ID 6608956966, 128 clinicians

Practice addresses (Care Compare)

3555 Cesar Chavez
San Francisco, CA 94110-4403
Phone (415) 485-8824

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
90
Promoting interoperability
100
Improvement activities
40
Cost
78.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C00141591CAMDInternal Medicine Physician
251033NYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newburgh Physician Services PC Hospitalist CurrentSince Oct 1, 2013 Accepting new patients
Quantum Healthcare Medical Associates Inc. Internal Medicine CurrentSince May 1, 2019 Accepting new patients
Pacific Inpatient Medical Group Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients

Locations

3555 Cesar Chavez
San Francisco, CA 94110
Phone (415) 485-8824

1101 Van Ness Ave
San Francisco, CA 94109
Phone (415) 485-8824

2800 Benedict Dr
San Leandro, CA 94577
Phone (510) 357-8300

66 W Gilbert St
Tinton Falls, NJ 07701
Phone (732) 212-0051

66 W Gilbert St
Ste 100
Tinton Falls, NJ 07701
Phone (201) 795-8637

70 Dubois St
Newburgh, NY 12550
Phone (845) 534-4673

Interoperability endpoints

  • Direct secure messaging: mthongcharoen538277@hisp.ehr.sutterhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1710132980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5870 N HIATUS RD",
            "address_2": "REGIONAL ADMIN OFFICE",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333216424",
            "telephone_number": "888-447-2362",
            "fax_number": "865-560-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 BENEDICT DR",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945776840",
            "telephone_number": "510-357-8300",
            "fax_number": "510-620-3924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THONGCHAROEN",
        "first_name": "MARUT",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-01",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "251033",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C00141591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

Verify at the official NPI Registry.