Individual provider Active NPI

Pichapong Tunsupon, M.D.

  • Pulmonary Disease Physician
  • Orlando, FL
National Provider Identifier
1821376096
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME129427 Issued in FL
Practice address
9430 Turkey Lake Rd Ste 110
Orlando, FL 32819-8015
Phone
(321) 841-7856
Fax
(321) 843-6432
NPI assigned
Jul 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 57.018973 OH
Critical Care Medicine (Internal Medicine) Physician 207RC0200X ME129427 FL
Student in an Organized Health Care Education/Training Program 390200000X
Pulmonary Disease Physician 207RP1001X ME129427 FL Primary

Addresses

Primary practice location

9430 Turkey Lake Rd Ste 110
Orlando, FL 32819-8015

Mailing address

9430 Turkey Lake Rd Ste 110
Orlando, FL 32819-8015
Phone (321) 841-7856

Other identifiers 1

IdentifierTypeStateIssuer
021282900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20170731003723 FL Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 2769753375 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

9400 Turkey Lake Rd
Orlando, FL 32819-8001
Phone (407) 354-1202

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.018973OHMDInternal Medicine Physician
ME129427FLMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Sep 2, 2020 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jul 15, 2021 Accepting new patients
Florida Hospital Medical Group Inc Internal Medicine CurrentSince Sep 2, 2020 Accepting new patients
Orlando Health Medical Group Inc Internal Medicine CurrentSince Jul 15, 2021 Accepting new patients
Pulmonary Disease Specialists, PA Pulmonary Disease CurrentSince Jun 1, 2020 Accepting new patients
Orlando Health, Inc. Current Accepting new patients

Locations

110 Park Place Blvd
Davenport, FL 33837
Phone (863) 419-0104

1121 N Central Ave
Kissimmee, FL 34741
Phone (407) 933-1221

290 Park Place Blvd
Kissimmee, FL 34741
Phone (407) 933-1221

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

9430 Turkey Lake Rd
Ste 110
Orlando, FL 32819
Phone (407) 370-8705

9400 Turkey Lake Rd
Orlando, FL 32819
Phone (321) 843-5500

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: ptunsupon179059@orlandohealth.medalliesdirect.net

Organizations & group practices 6

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 5

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": "1311292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1821376096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9430 TURKEY LAKE RD STE 110",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328198015",
            "telephone_number": "321-841-7856",
            "fax_number": "321-843-6432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9430 TURKEY LAKE RD STE 110",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328198015",
            "telephone_number": "321-841-7856",
            "fax_number": "321-843-6432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUNSUPON",
        "first_name": "PICHAPONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-22",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.018973",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "ME129427",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME129427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021282900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.