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CHAIVAT PHUVADAKORN M.D.
NPI 1164793816
Internal Medicine - Geriatric Medicine in Los Angeles, CA

Active since January 25, 2012PECOS Enrolled
351 E TEMPLE ST, MAIL CODE LAACC HOME BASED PRIMARY CARE A127A, LOS ANGELES, CA 90012(213) 253-5018(213) 253-5018 Get Directions Write a Review

NPPES record last updated: May 8, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 8, 2024, Aug 14, 2023, Feb 1, 2017 (3 updates tracked since 2017).

About Chaivat Phuvadakorn M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHAIVAT PHUVADAKORN M.D. (NPI 1164793816) is an individual geriatric medicine provider in Los Angeles, California, licensed in California (122504) and active in the NPI registry since January 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164793816
Entity TypeIndividualMale
Primary Taxonomy207RG0300X
Provider Legal NameCHAIVAT PHUVADAKORNCredential: M.D.
Location Address351 E TEMPLE ST, MAIL CODE LAACC HOME BASED PRIMARY CARE A127ALos Angeles, CA 90012-3328
Mailing Address1322 E Maple StGlendale, CA 91205-2607 · (424) 236-2767 · Fax (213) 253-5017
Phone(213) 253-5018
Fax(213) 253-5018
Sole ProprietorYes
Enumeration DateJanuary 25, 2012
Last NPPES UpdateMay 8, 20243 updates tracked since enumeration
NPPES CertifiedMay 8, 2024
✔ NPI 1164793816 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RG0300X
License✔ Licensed in CA · 122504
Definition
An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.
Also ListedInternal MedicineTaxonomy 207R00000X · License A122504 (CA)
351 E TEMPLE ST, Los Angeles, CA 90012
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Chaivat Phuvadakorn M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90012 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$187.60 typical visit price
range $62.96 – $187.60
Typical copayment $46.90 (range $15.74 – $46.90)
Most-billed visit code 99205
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LUIS ARMANDO ESPANA JR. ACSW
Social Worker
351 E TEMPLE ST
LOS ANGELES, CA 90012
Los Angeles County (213) 440-8713
DR. KIMBERLY KELLY M.D.
Psychiatry & Neurology (Neurology)
351 E TEMPLE ST
LOS ANGELES, CA 90012
Los Angeles County (213) 253-2677
LA VETERANS AFFAIRS
Clinic/Center (VA)
351 E TEMPLE ST
LOS ANGELES, CA 90012
Los Angeles County (213) 253-2677
MR. JOEL STOUP LCSW
Social Worker (Clinical)
351 E TEMPLE ST
LOS ANGELES, CA 90012
Los Angeles County (213) 253-2677
DR. BRITTANY NICKELS PSY.D.
Psychologist (Clinical)
351 E TEMPLE ST, HOME-BASED PRIMARY CARE, RM A127A
LOS ANGELES, CA 90012
Los Angeles County (310) 810-5136
DR. CHANG H KIM OD
Optometrist
351 E TEMPLE ST
LOS ANGELES, CA 90012
Los Angeles County (213) 253-2677
MRS. MARIALENA JOANNE NICHOLS R.N.
Registered Nurse (Case Management)
351 E TEMPLE ST
LOS ANGELES, CA 90012
Los Angeles County (213) 253-2677
SOUTHERN CALIFORNIA MEDICAL GASTROENTEROLOGY GROUP, INC
Clinic/Center (Ambulatory Surgical)
351 E TEMPLE ST
LOS ANGELES, CA 90012
Los Angeles County (310) 829-6789

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 Chaivat Phuvadakorn's NPI number?

The NPI number for Chaivat Phuvadakorn is 1164793816. It was assigned to this individual provider in the NPPES registry on January 25, 2012.

Where is Chaivat Phuvadakorn located?

Chaivat Phuvadakorn practices at 351 E Temple St Mail Code Laacc Home Based Primary Care A127a, Los Angeles, CA 90012. The listed phone number is (213) 253-5018.

What is Chaivat Phuvadakorn's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.

Is Chaivat Phuvadakorn enrolled in Medicare?

Yes. Chaivat Phuvadakorn is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Chaivat Phuvadakorn was last updated on May 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.