Kongsak Tanphaichitr, M.D.

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

35104 Issued in MO

Practice address

11115 New Halls Ferry Rd
Suite 102
Florissant, MO 63033-7613

Phone

(314) 839-4339

Fax

(314) 839-0011

NPI assigned

Dec 15, 2006

Sex

Male

Sole proprietor

Yes

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 MO

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

Practice roles

Interoperability endpoints

• Direct secure messaging: drtanphaichitr@tanp281.powersoftmdsecure.com
• Direct secure messaging: ktanphaichitr154945@direct.carenet.org

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.

• North St Louis County General Surgery Inc

  • Surgery Physician
  • Florissant, MO
  • NPI 1306926761
  NPD (past)
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1962442475
  NPD (past)

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343952000000",
    "number": "1942362777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11115 NEW HALLS FERRY RD",
            "address_2": "SUITE 102",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630337613",
            "telephone_number": "314-839-4339",
            "fax_number": "314-839-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11115 NEW HALLS FERRY RD",
            "address_2": "SUITE 102",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630337613",
            "telephone_number": "314-839-4339",
            "fax_number": "314-839-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANPHAICHITR",
        "first_name": "KONGSAK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2012-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "MO",
            "license": "35104",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MO",
            "license": "35104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200861813",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenlicia Tabb, PHARMD, RPH
• Bessevelyn M. Tables, M.D.
• Ernst Martin Taeger
• Angela Talton, APRN, FNP-BC
• Yirui Tang
• Erica Michelle Tate
• Sky'Lar Tate
• Brett Tatko, PT
• Patricia Lee Tavares, PHARMD
• Annabelle Taylor, LPTA, CFO

• Rheumatology Physician in Florissant, MO
• Providers in Florissant, MO by specialty
• Rheumatology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2012; 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.