Chanika Phornphutkul, MD - Medicare Pediatric Medicine in Providence, RI

  1. Home
Chanika Phornphutkul, MD is a medicare enrolled "Medical Genetics - Clinical Biochemical Genetics" physician in Providence, Rhode Island. She graduated from medical school in 1992 and has 33 years of diverse experience with area of expertise as Pediatric Medicine. She is a member of the group practice Rhode Island Hospital and her current practice location is 593 Eddy St, Providence, Rhode Island. You can reach out to her office (for appointments etc.) via phone at (401) 444-8361.

Chanika Phornphutkul is licensed to practice in Rhode Island (license number MD10121) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1639124530.

Contact Information

Chanika Phornphutkul, MD
593 Eddy St,
Providence, RI 02903-4923
(401) 444-8361
(401) 444-3288

Map and Direction




Physician's Profile

Full NameChanika Phornphutkul
GenderFemale
SpecialityPediatric Medicine
Experience33 Years
Location593 Eddy St, Providence, Rhode Island
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Chanika Phornphutkul graduated from medical school in 1992
  NPI Data:
  • NPI Number: 1639124530
  • Provider Enumeration Date: 05/23/2006
  • Last Update Date: 12/21/2011
  Medicare PECOS Information:
  • PECOS PAC ID: 2668486754
  • Enrollment ID: I20130403000436

Medical Identifiers

Medical identifiers for Chanika Phornphutkul such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1639124530NPI-NPPES
CP46587MedicaidRI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2080P0205XPediatrics - Pediatric Endocrinology 10121 (Rhode Island)Secondary
207SG0202XMedical Genetics - Clinical Biochemical Genetics MD10121 (Rhode Island)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Rhode Island HospitalProvidence, RIHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Rhode Island Hospital8921900044349

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Chanika Phornphutkul allows following entities to bill medicare on her behalf.
Entity NameRhode Island Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1861420333
PECOS PAC ID: 8921900044
Enrollment ID: O20040121000169
Entity NameRhode Island Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1396849782
PECOS PAC ID: 8921900044
Enrollment ID: O20050211000311
Entity NameAffinity Physicians Llc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1184944662
PECOS PAC ID: 0244413391
Enrollment ID: O20110326000053
Entity NameThe Miriam Hospital
Entity TypePart B Supplier - Hospital Department(s)
Entity IdentifiersNPI Number: 1164716031
PECOS PAC ID: 6901796408
Enrollment ID: O20110928000027
Entity NameLifespan Physician Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1407116643
PECOS PAC ID: 2567455082
Enrollment ID: O20121029000368

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Chanika Phornphutkul is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Chanika Phornphutkul, MD
593 Eddy St, Hasbro 122,
Providence, RI 02903-4923

Ph: (401) 444-8361		Chanika Phornphutkul, MD
593 Eddy St,
Providence, RI 02903-4923

Ph: (401) 444-8361

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.