SURASAK PHUPHANICH M.D.
NPI 1457469074
Psychiatry & Neurology - Neurology in West Hollywood, CA
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 and maintains 2 additional practice locations.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 2
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Surasak Phuphanich M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Surasak Phuphanich reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Orange, CA 92868
- Reassigned Medicare billing, California enrollment
- 135 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 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.
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.
WEST HOLLYWOOD, CA 90048
WEST HOLLYWOOD, CA 90048
WEST HOLLYWOOD, CA 90048
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.
Which organization bills Medicare for Surasak Phuphanich's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Surasak Phuphanich reassigns Medicare benefits to Regents Of The University Of Claifornia Univ Neursciences (Orange, CA). 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 Surasak Phuphanich'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 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 7 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.
# Surasak Phuphanich, M.D. · NPI 1457469074
Neurology physician in West Hollywood, California. Individual provider, active in the CMS NPPES registry since August 25, 2006.
## Identity
- **NPI:** 1457469074 (Entity type: Individual)
- **Enumerated:** August 25, 2006
- **Primary specialty:** Psychiatry & Neurology - Neurology · taxonomy 2084N0400X
- **State license:** A36229 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 8700 BEVERLY BLVD, West Hollywood, CA 90048
- **Phone:** (310) 423-5000
## 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:** Regents Of The University Of Claifornia Univ Neursciences (NPI 1205884210, Orange, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 3, 2019
- **Other identifiers:** Medicaid 266604 (AZ)
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Source: [NPI Profile](https://npiprofile.com/npi/1457469074) · Data from the CMS NPPES public registry.