NPIMap

Individual provider Active NPI

Phumpattra Chariyawong, MD

  • Hospitalist Physician
  • Portland, ME
National Provider Identifier
1740665553
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD30158 Issued in ME
Practice address
22 Bramhall St
Portland, ME 04102-3134
Phone
(207) 662-4618
Fax
(207) 662-6254
NPI assigned
Jul 22, 2015
Last updated
Mar 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X T3600 TX
Internal Medicine Physician 207R00000X MD30158 ME
Hospitalist Physician 208M00000X MD30158 ME Primary

Addresses

Primary practice location

22 Bramhall St
Portland, ME 04102-3134

Mailing address

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-4618

Other practice location 1

3315 S Alameda St
Corpus Christi, TX 78411-1820
Phone (877) 332-4602

Other practice location 2

25 June St
Sanford, ME 04073-2621
Phone (207) 324-4310

Other practice location 3

1 Medical Center Dr
Biddeford, ME 04005-9422
Phone (207) 283-7937

Other identifiers 1

IdentifierTypeStateIssuer
T3600OtherTXTEXAS MEDICAL BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, ME2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211028001288 TX Practitioner - Internal MedicinePractitioner - Nephrology 7315246337 Reassigns benefits to 2 organizations
I20260413003670 ME Practitioner - HospitalistPractitioner - Internal Medicine 7315246337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians
HHA Hospital Medicine of Texas PLLCGroup PAC ID 7618329079, 27 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

7101 S Padre Island Dr
Corpus Christi, TX 78412-4913
Phone (877) 832-2652

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD30158MEMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HHA Hospital Medicine of Texas PLLC Hospitalist CurrentSince Dec 1, 2024 Accepting new patients
Corpus Christi Hospitalists, PLLC Internal Medicine CurrentSince Oct 25, 2021 Accepting new patients
Bay Area Healthcare Group, LTD. Past Accepting new patients

Locations

3315 S Alameda St
Corpus Christi, TX 78411
Phone (361) 761-1400

7101 S Padre Island Dr
Corpus Christi, TX 78412
Phone (361) 761-1400

110 Memorial Hospital Dr
Huntsville, TX 77340
Phone (936) 291-4276

Organizations & group practices 4

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 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1437523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1740665553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-4618",
            "fax_number": "207-662-6254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-4618",
            "fax_number": "207-662-6254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3315 S Alameda St",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784111820",
            "country_code": "US",
            "telephone_number": "877-332-4602",
            "fax_number": "361-857-0572",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 June St",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "ME",
            "postal_code": "040732621",
            "country_code": "US",
            "telephone_number": "207-324-4310",
            "fax_number": "207-490-7999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Biddeford",
            "state": "ME",
            "postal_code": "040059422",
            "country_code": "US",
            "telephone_number": "207-283-7937",
            "fax_number": "207-283-7018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARIYAWONG",
        "first_name": "PHUMPATTRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-22",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T3600",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "MD30158",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ME",
            "license": "MD30158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD",
            "identifier": "T3600",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.