DR. THOTSOPHON TAECHARIYAKUL MD
NPI 1063031243
Student in an Organized Health Care Education/Training Program in Lebanon, NH
About Dr. Thotsophon Taechariyakul Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. THOTSOPHON TAECHARIYAKUL MD (NPI 1063031243) is an individual student in an organized health care education/training program in Lebanon, New Hampshire and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS, is affiliated with Stephens County Hospital, and is a graduate of Oregon Health Sciences University School Of Medicine (2020).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Thotsophon Taechariyakul Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Thotsophon Taechariyakul reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Atlanta, GA 30342
- Reassigned Medicare billing, California and New Hampshire enrollments
- 38 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 5
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Stephens County Hospital
Acute Care Hospitals · Toccoa, GAPiedmont Columbus Regional Midtown
Acute Care Hospitals · Columbus, GAPiedmont Columbus Regional Northside
Acute Care Hospitals · Columbus, GAWills Memorial Hospital
Critical Access Hospitals · Washington, GAElbert Memorial Hospital
Critical Access Hospitals · Elberton, GAOther Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LEBANON, NH 03756
LEBANON, NH 03756
LEBANON, NH 03756
LEBANON, NH 03756
LEBANON, NH 03756
LEBANON, NH 03756
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Thotsophon Taechariyakul's NPI number?
The NPI number for Thotsophon Taechariyakul is 1063031243. It was assigned to this individual provider in the NPPES registry on April 8, 2020.
Where is Thotsophon Taechariyakul located?
Thotsophon Taechariyakul practices at 1 Medical Center Dr, Lebanon, NH 03756. The listed phone number is (603) 650-7480.
What is Thotsophon Taechariyakul's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Thotsophon Taechariyakul enrolled in Medicare?
Yes. Thotsophon Taechariyakul is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Thotsophon Taechariyakul's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Thotsophon Taechariyakul reassigns Medicare benefits to Northside Radiology Associates LLC (Atlanta, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Thotsophon Taechariyakul's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Thotsophon Taechariyakul affiliated with any hospitals?
According to CMS data, Thotsophon Taechariyakul is affiliated with Stephens County Hospital, Piedmont Columbus Regional Midtown, Piedmont Columbus Regional Northside, Wills Memorial Hospital and Elbert Memorial Hospital.
When was this NPI record last updated?
The NPPES record for Thotsophon Taechariyakul was last updated on June 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Thotsophon Taechariyakul, MD · NPI 1063031243
Student in an Organized Health Care Education/Training Program provider in Lebanon, New Hampshire. Individual provider, active in the CMS NPPES registry since April 8, 2020.
## Identity
- **NPI:** 1063031243 (Entity type: Individual)
- **Enumerated:** April 8, 2020
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 1 MEDICAL CENTER DR, Lebanon, NH 03756-0001
- **Phone:** (603) 650-7480
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Northside Radiology Associates LLC (NPI 1013960657, Atlanta, GA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Oregon Health Sciences University School Of Medicine, class of 2020
## Record status
- **NPPES last updated:** June 12, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1063031243) · Data from the CMS NPPES public registry.