Pairote Jaroonwanichkul, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

102149 Issued in MO

Practice address

1723 Broadway St
Suite 315
Cape Girardeau, MO 63701-4505

Phone

(573) 331-6476

Fax

(573) 331-6526

NPI assigned

Jul 5, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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 1

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.

• Mendota Community Hospital

  • Critical Access Hospital
  • Mendota, IL
  • NPI 1609803113
  Medicare reassignment NPD
• Southern Illinois Medical Services, NFP

  • Internal Medicine Physician
  • Carbondale, IL
  • NPI 1770656837
  Medicare reassignment NPD
• Branson Oncology Clinic, L.L.C.

  • Specialist
  • Branson, MO
  • NPI 1841313475
  NPD (past) Authorized official

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1801893979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3655 VISTA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102539",
            "telephone_number": "314-977-4340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 BROADWAY ST",
            "address_2": "SUITE 315",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014505",
            "telephone_number": "573-331-6476",
            "fax_number": "573-331-6526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAROONWANICHKUL",
        "first_name": "PAIROTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IL",
            "license": "036084741",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MO",
            "license": "102149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203568217",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James John James, PTA
• Kayla Rochelle Jamieson
• Jacob C Janet, OD
• Kelsie Nicole Jansen, APRN
• Marilyn J Jansen, PA-C
• Mary Elizabeth Jarrells, FNP-BC
• Wendy Maria Jauch, APRN
• Michael T Jedlinski, M.D.
• Jefferson Manor
• Jefferson Manor Cape Girardeau

• Hematology & Oncology Physician in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Hematology & Oncology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.