KANOKPORN MONGKOLRATTANOTHAI MD
NPI 1174592950
Pediatrics in Los Angeles, CA
About Kanokporn Mongkolrattanothai Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KANOKPORN MONGKOLRATTANOTHAI MD (NPI 1174592950) is an individual pediatrics provider in Los Angeles, California, licensed in Illinois (036112843) and active in the NPI registry since March 2006. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kanokporn Mongkolrattanothai Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Kanokporn Mongkolrattanothai reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Los Angeles, CA 90027
- Reassigned Medicare billing, California enrollment
- Medicare enrollment name: Childrens Hospital Los Angeles Medical Group Inc
- 1,281 clinicians in this Medicare group
Los Angeles, CA 90027
- Reassigned Medicare billing, California enrollment
- 13,921 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 90027 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
LOS ANGELES, CA 90027
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 Kanokporn Mongkolrattanothai's NPI number?
The NPI number for Kanokporn Mongkolrattanothai is 1174592950. It was assigned to this individual provider in the NPPES registry on March 15, 2006.
Where is Kanokporn Mongkolrattanothai located?
Kanokporn Mongkolrattanothai practices at 4650 W Sunset Blvd Mailstop # 51, Los Angeles, CA 90027. The listed phone number is (323) 361-8736.
What is Kanokporn Mongkolrattanothai's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Kanokporn Mongkolrattanothai enrolled in Medicare?
Yes. Kanokporn Mongkolrattanothai is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Kanokporn Mongkolrattanothai's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kanokporn Mongkolrattanothai reassigns Medicare benefits to 2 organizations: Children's Hospital Los Angeles Medical Group, Inc. (Los Angeles, CA) and Southern California Permanente Medical Group (Los Angeles, CA). Each 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 Kanokporn Mongkolrattanothai's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kanokporn Mongkolrattanothai was last updated on May 7, 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.
# Kanokporn Mongkolrattanothai, MD · NPI 1174592950
Pediatrics physician in Los Angeles, California. Individual provider, active in the CMS NPPES registry since March 15, 2006.
## Identity
- **NPI:** 1174592950 (Entity type: Individual)
- **Enumerated:** March 15, 2006
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** 036112843 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 4650 W SUNSET BLVD, MAILSTOP # 51, Los Angeles, CA 90027-6062
- **Phone:** (323) 361-8736 · **Fax:** (323) 361-1183
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Children's Hospital Los Angeles Medical Group, Inc. (NPI 1265530653, Los Angeles, CA); Southern California Permanente Medical Group (NPI 1134151657, Los Angeles, CA) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 7, 2024
- **Other identifiers:** Other 07215036 (IL); Medicaid 036112843 (IL)
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Source: [NPI Profile](https://npiprofile.com/npi/1174592950) · Data from the CMS NPPES public registry.