Porntip Chungchansat, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E6282 Issued in TX

Practice address

416 Frankford
Lubbock, TX 79416

Phone

(806) 725-5410

Fax

(806) 792-7157

NPI assigned

Apr 11, 2006

Sex

Female

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

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Lubbock Children'S Health Clinic

  • Pediatrics Physician
  • Lubbock, TX
  • NPI 1548288475
  NPD (past)

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1720041429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 22ND PLACE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79410",
            "telephone_number": "806-725-7800",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 FRANKFORD",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79416",
            "telephone_number": "806-725-5410",
            "fax_number": "806-792-7157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNGCHANSAT",
        "first_name": "PORNTIP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "E6282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138095812",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher R. Rose, MD PA
• Chromatox Diagnostics, LLC
• James Chua-Tuan, M.D.
• Hye Soo Chung, DMD
• Joanne Younbok Chung, MD
• Jonathan Christopher Ciaccio, RPH
• City of Ennis
• City of Lubbock
• City of Lubbock
• City of Lubbock Health Department

• Family Medicine Physician in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; 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.