Miss Khemaporn Lertdetkajorn, MD in Riverdale, GA

Miss Khemaporn Lertdetkajorn, MD is a medicare enrolled "Internal Medicine - Endocrinology, Diabetes & Metabolism" physician in Riverdale, Georgia. She graduated from medical school in 2015 and has 11 years of diverse experience with area of expertise as Internal Medicine. She is a member of the group practice Southern Regional Physicians Management Group, Llc and her current practice location is 33 Upper Riverdale Rd Sw Ste 111, Riverdale, Georgia. You can reach out to her office (for appointments etc.) via phone at (770) 909-2045.

Miss Khemaporn Lertdetkajorn is licensed to practice in Georgia (license number 100193) 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 1871089367.

Contact Information

	Miss Khemaporn Lertdetkajorn, MD
	33 Upper Riverdale Rd Sw Ste 111, Riverdale, GA 30274-2642
	(770) 909-2045
	(770) 909-2056

Map and Direction

Physician's Profile

Full Name	Miss Khemaporn Lertdetkajorn
Gender	Female
Speciality	Internal Medicine
Experience	11 Years
Location	33 Upper Riverdale Rd Sw Ste 111, Riverdale, Georgia
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Miss Khemaporn Lertdetkajorn graduated from medical school in 2015

NPI Data:

NPI Number: 1871089367
Provider Enumeration Date: 07/08/2018
Last Update Date: 06/30/2026

Medicare PECOS Information:

PECOS PAC ID: 8820407059
Enrollment ID: I20250204002822

Medical Identifiers

Medical identifiers for Miss Khemaporn Lertdetkajorn such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1871089367	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207RE0101X	Internal Medicine - Endocrinology, Diabetes & Metabolism	100193 (Georgia)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Southern Regional Medical Center	Riverdale, GA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Southern Regional Physicians Management Group, Llc	9032491956	28

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. Miss Khemaporn Lertdetkajorn allows following entities to bill medicare on her behalf.

Entity Name	Southern Regional Physicians Management Group, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043677271 PECOS PAC ID: 9032491956 Enrollment ID: O20170127002483

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. Miss Khemaporn Lertdetkajorn 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 Address	Practice Location Address
Miss Khemaporn Lertdetkajorn, MD 33 Upper Riverdale Rd Sw Ste 111, Riverdale, GA 30274-2642 Ph: (770) 909-2045	Miss Khemaporn Lertdetkajorn, MD 33 Upper Riverdale Rd Sw Ste 111, Riverdale, GA 30274-2642 Ph: (770) 909-2045

Reviews and Comments

Internal Medicine Doctors in Riverdale, GA

Dr. Jay R Prakash, M.D. Endocrinology, Diabetes & Metabolism Medicare: Medicare Enrolled Practice Location: 6555 Professional Pl, Suite C, Riverdale, GA 30274 Phone: 770-996-5959 Fax: 770-991-1596
Paul L Harvey, MD Endocrinology, Diabetes & Metabolism Medicare: Accepting Medicare Assignments Practice Location: 483 Upper Riverdale Rd Sw Ste G, Riverdale, GA 30274 Phone: 770-996-9400 Fax: 770-991-2918
Dr. Eloy Edilberto Diaz Sr., M.D. Endocrinology, Diabetes & Metabolism Medicare: Accepting Medicare Assignments Practice Location: 6572 River Park Dr Ste 102, Riverdale, GA 30274 Phone: 770-629-2296
Rajinikanth Seshan, M.D. Endocrinology, Diabetes & Metabolism Medicare: Accepting Medicare Assignments Practice Location: 253 Upper Riverdale Rd Sw, Suite B, Riverdale, GA 30274 Phone: 216-533-8842
Dr. Victor Ezinna Okeh, M.D. Endocrinology, Diabetes & Metabolism Medicare: Accepting Medicare Assignments Practice Location: 483 Upper Riverdale Rd Sw Ste F, Riverdale, GA 30274 Phone: 770-742-3883 Fax: 855-597-8504
Dr. Michael Angel Dicristina, M.D. Endocrinology, Diabetes & Metabolism Medicare: Medicare Enrolled Practice Location: 33 Upper Riverdale Rd Sw, Suite 21, Riverdale, GA 30274 Phone: 770-968-7933 Fax: 770-968-6521
Sadrudin J Sarangi, M D Endocrinology, Diabetes & Metabolism Medicare: Not Enrolled in Medicare Practice Location: 150 Medical Way, Suite B - 1, Riverdale, GA 30274 Phone: 770-991-1600 Fax: 770-991-1616

Miss Khemaporn Lertdetkajorn, MD - Medicare Internal Medicine in Riverdale, GA