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SURASAK PHUPHANICH M.D.
NPI 1457469074
Psychiatry & Neurology - Neurology in West Hollywood, CA

Active since August 25, 2006PECOS Enrolled
8700 BEVERLY BLVD, WEST HOLLYWOOD, CA 90048(310) 423-5000 Get Directions Write a Review

NPPES record last updated: October 3, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 3, 2019, Sep 17, 2018 (2 updates tracked since 2018).

About Surasak Phuphanich M.d. NPPES

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

SURASAK PHUPHANICH M.D. (NPI 1457469074) is an individual neurology provider in West Hollywood, California, licensed in California (A36229) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1457469074
Entity TypeIndividualMale
Primary Taxonomy2084N0400X
Provider Legal NameSURASAK PHUPHANICHCredential: M.D.
Location Address8700 BEVERLY BLVDWest Hollywood, CA 90048
Mailing AddressPo Box 512717Los Angeles, CA 90051-0717
Phone(310) 423-5000
Sole ProprietorNo
Enumeration DateAugust 25, 2006
Last NPPES UpdateOctober 3, 20192 updates tracked since enumeration
✔ NPI 1457469074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
Licenses✔ Licensed in CA · A36229✔ Licensed in AZ · 53135
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Also ListedInternal Medicine · Medical OncologyTaxonomy 207RX0202X · License 53514 (GA)
8700 BEVERLY BLVD, West Hollywood, CA 90048
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Other Identifiers 1

Medicaid266604AZ

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Surasak Phuphanich 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 90048 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
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
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.

DR. BERNICE LOUISE COLEMAN PH.D, ACNP-BC
Nurse Practitioner (Acute Care)
8700 BEVERLY BLVD, NORTH TOWER ROOM 6215
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-6178
DR. INGRID LEAH DOMBROWER M.D.
Psychiatry & Neurology (Psychiatry)
8700 BEVERLY BLVD
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-2871
ELAINE WITTERT MSW
Social Worker (Clinical)
8700 BEVERLY BLVD, SUITE AC1002
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-3119
DR. KENAN MOHAMMED NADAR D.O.
Pediatrics
8700 BEVERLY BLVD
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-4451
HAE YOON GRACE CHOUNG MD
Pathology (Anatomic Pathology & Clinical Pathology)
8700 BEVERLY BLVD
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-6623
CASEY DISTASO MD
Emergency Medicine
8700 BEVERLY BLVD
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-8780
CHIARA CASAS NP
Nurse Practitioner (Pediatrics)
8700 BEVERLY BLVD
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-3277
PHILIP CHENG MD
Student in an Organized Health Care Education/Training Program
8700 BEVERLY BLVD
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-1682

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 Surasak Phuphanich's NPI number?

The NPI number for Surasak Phuphanich is 1457469074. It was assigned to this individual provider in the NPPES registry on August 25, 2006.

Where is Surasak Phuphanich located?

Surasak Phuphanich practices at 8700 Beverly Blvd, West Hollywood, CA 90048. The listed phone number is (310) 423-5000.

What is Surasak Phuphanich's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Surasak Phuphanich enrolled in Medicare?

Yes. Surasak Phuphanich is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Surasak Phuphanich was last updated on October 3, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.