Individual provider Active NPI

Danai Khemasuwan, M.D.

  • Pulmonary Disease Physician
  • Brighton, MA
National Provider Identifier
1912104860
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
9396470-1205 Issued in UT
Practice address
77 Warren St FL 2
Brighton, MA 02135-3601
Phone
(617) 789-2545
Fax
(617) 779-6798
NPI assigned
Jul 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 9396470-1205 UT Primary

Addresses

Primary practice location

77 Warren St FL 2
Brighton, MA 02135-3601

Mailing address

77 Warren St FL 2
Brighton, MA 02135-3601
Phone (617) 789-2545

Other identifiers 1

IdentifierTypeStateIssuer
273373OtherMAMA LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address danai.khemasuwan@direct.imail.org

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
I20201130002719 VA Practitioner - Critical Care (Intensivists)Practitioner - Pulmonary Disease 2466638341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Pulmonary Disease
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians
Intensive Care Consortium IncGroup PAC ID 0244269413, 485 clinicians

Practice addresses (Care Compare)

1213 E Clay St
Richmond, VA 23298-5071
Phone (804) 828-9000

1602 Skipwith Rd
Richmond, VA 23229-5205
Phone (615) 372-3372

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9396470-1205UTMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians CurrentSince Aug 22, 2020 Accepting new patients
Intensive Care Consortium Inc CurrentSince Nov 20, 2020 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

417 N 11th St
Richmond, VA 23298
Phone (804) 828-0733

1213 E Clay St
Richmond, VA 23298
Phone (804) 827-1207

1602 Skipwith Rd
Richmond, VA 23229
Phone (804) 289-4500

1900 Electric Rd
Salem, VA 24153
Phone (540) 772-3400

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.

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": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1912104860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 WARREN ST FL 2",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021353601",
            "telephone_number": "617-789-2545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 WARREN ST FL 2",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021353601",
            "telephone_number": "617-789-2545",
            "fax_number": "617-779-6798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHEMASUWAN",
        "first_name": "DANAI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "UT",
            "license": "9396470-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MA LICENSE",
            "identifier": "273373",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "danai.khemasuwan@direct.imail.org",
            "affiliation": "N",
            "address_1": "5121 S Cottonwood St",
            "city": "Murray",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841075701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brighton, MA

Sources for this page

Verify at the official NPI Registry.