Individual provider Active NPI

Prapaipan Putthapiban, MD

  • Internal Medicine Physician
  • Richmond, VA
National Provider Identifier
1891225082
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101276459 Issued in VA
Practice address
1712 E Broad St
Richmond, VA 23223-6930
Phone
(804) 344-9848
Fax
(804) 554-5395
NPI assigned
Jun 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101276459 VA Primary

Addresses

Primary practice location

1712 E Broad St
Richmond, VA 23223-6930

Mailing address

1712 E Broad St
Richmond, VA 23223-6930
Phone (804) 344-9848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20230306001673 VA Practitioner - Internal Medicine 1850764234 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PMR Virginia Holding, LLC CurrentSince Apr 1, 2023 Accepting new patients
Jencare Neighborhood Medical East Richmond, LLC Internal Medicine PastSince Sep 4, 2012 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

1712 E Broad St
Richmond, VA 23223
Phone (804) 344-9848

3806 Mechanicsville Tpke
Richmond, VA 23223
Phone (804) 228-1143

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1891225082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 E BROAD ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232236930",
            "telephone_number": "804-344-9848",
            "fax_number": "804-554-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 E BROAD ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232236930",
            "telephone_number": "804-344-9848",
            "fax_number": "804-554-5395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTTHAPIBAN",
        "first_name": "PRAPAIPAN",
        "name_prefix": "Miss",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101276459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.