NPIMap

Individual provider Active NPI

Makhawadee Pongruangporn, MD

  • Infectious Disease Physician
  • Louisville, KY
National Provider Identifier
1801054838
Registry record updated Mar 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
48026 Issued in KY
Practice address
4950 Norton Healthcare Blvd
Ste.303
Louisville, KY 40241-2845
Phone
(502) 394-6470
Fax
(502) 394-6477
NPI assigned
May 27, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 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 2012012189 MO
Infectious Disease Physician 207RI0200X 48026 KY Primary

Addresses

Primary practice location

4950 Norton Healthcare Blvd
Ste.303
Louisville, KY 40241-2845

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other identifiers 1

IdentifierTypeStateIssuer
7100361830MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150224000411 KY Practitioner - Infectious Disease 6507014461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

4915 Norton Healthcare Blvd
Suite 103
Louisville, KY 40241-2832
Phone (502) 446-6635

4955 Norton Healthcare Blvd
FL 2
Louisville, KY 40241-2832
Phone (502) 394-6350

4960 Norton Healthcare Blvd
Louisville, KY 40241-2831
Phone (502) 446-8125

825 Barret Ave
Louisville, KY 40204-1743
Phone (502) 272-5165

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48026KYMDInfectious Disease Physician
2012012189MOMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. CurrentSince Mar 1, 2015 Accepting new patients
Community Medical Associates, Inc. Infectious Disease CurrentSince Mar 1, 2015 Accepting new patients

Locations

315 E Broadway
Fl 4
Louisville, KY 40202
Phone (502) 272-5165

315 E Broadway
Ste 195
Louisville, KY 40202
Phone (502) 589-5961

315 E Broadway
Ste 192
Louisville, KY 40202
Phone (502) 861-4488

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

4950 Norton Healthcare Blvd
Ste 303
Louisville, KY 40241
Phone (502) 394-6470

Interoperability endpoints

  • Direct secure messaging: mpongruangporn87465@direct.nortonhealthcare.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 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553126400000",
    "number": "1801054838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 NORTON HEALTHCARE BLVD",
            "address_2": "STE.303",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402412845",
            "telephone_number": "502-394-6470",
            "fax_number": "502-394-6477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONGRUANGPORN",
        "first_name": "MAKHAWADEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-27",
        "last_updated": "2019-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2012012189",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "KY",
            "license": "48026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100361830",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.