CHANAVUTH KANITSORAPHAN MD
NPI 1205329216
Internal Medicine in Honolulu, HI

Q: What is Chanavuth Kanitsoraphan's NPI number?

The NPI number for Chanavuth Kanitsoraphan is 1205329216. It was assigned to this individual provider in the NPPES registry on June 13, 2018.

Q: What is Chanavuth Kanitsoraphan's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since June 13, 2018PECOS Enrolled

1356 LUSITANA ST STE 510, HONOLULU, HI 96813(808) 462-2776 Get Directions Write a Review

NPPES record last updated: June 13, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 13, 2025, Jun 13, 2018 (2 updates tracked since 2018).

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About Chanavuth Kanitsoraphan Md NPPES

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

CHANAVUTH KANITSORAPHAN MD (NPI 1205329216) is an individual internal medicine provider in Honolulu, Hawaii, licensed in Illinois (036159623) and active in the NPI registry since June 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205329216

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameCHANAVUTH KANITSORAPHANCredential: MD

Location Address1356 LUSITANA ST STE 510Honolulu, HI 96813-2409

Mailing Address1356 Lusitana St Ste 510Honolulu, HI 96813-2409 · (808) 462-2776

Phone(808) 462-2776

Sole ProprietorNo

Enumeration DateJune 13, 2018

Last NPPES UpdateJune 13, 20252 updates tracked since enumeration

NPPES CertifiedJune 13, 2025

✔ NPI 1205329216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in IL · 036159623

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1356 LUSITANA ST STE 510, Honolulu, HI 96813

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Chanavuth Kanitsoraphan Md 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.

Medicare Billing Reassignment

Medicare enrollment records show Chanavuth Kanitsoraphan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Multicare Health System

2,635 mi

Pediatrics

1920 BLACK LAKE BLVD SW
Olympia, WA 98512

Reassigned Medicare billing, Washington enrollment
4,383 clinicians in this Medicare group

NPI 1831609775 (360) 534-9222

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 96813 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

$136.68 typical visit price

range $60.53 – $180.05

Typical copayment $34.17 (range $15.13 – $45.01)

Most-billed visit code 99204

Established Patient

$105.65 typical visit price

range $20.09 – $147.56

Typical copayment $26.41 (range $5.02 – $36.89)

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 11

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

DR. RYOHEI HORIE M.D.

Student in an Organized Health Care Education/Training Program