DR. POYRUNG POYSOPHON MD
NPI 1609257435
Family Medicine - Sports Medicine in Corona, CA

Q: What is Poyrung Poysophon's NPI number?

The NPI number for Poyrung Poysophon is 1609257435. It was assigned to this individual provider in the NPPES registry on June 17, 2015.

Q: What is Poyrung Poysophon's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Q: When was this NPI record last updated?

The NPPES record for Poyrung Poysophon was last updated on December 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since June 17, 2015PECOS EnrolledAccepts Medicare Assignment

21634 RETREAT PKWY, CORONA, CA 92883(951) 493-6832 Get Directions Write a Review

NPPES record last updated: December 8, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 8, 2021, Feb 24, 2020, Jul 26, 2019 and 1 more (4 updates tracked since 2019).

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About Dr. Poyrung Poysophon Md NPPES

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

DR. POYRUNG POYSOPHON MD (NPI 1609257435) is an individual sports medicine provider in Corona, California, licensed in California (A015875) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1609257435

Entity TypeIndividualFemale

Primary Taxonomy207QS0010X

Provider Legal NameDR. POYRUNG POYSOPHONCredential: MD

Location Address21634 RETREAT PKWYCorona, CA 92883-6100

Mailing Address21634 Retreat PkwyCorona, CA 92883-6100 · (951) 493-6832

Phone(951) 493-6832

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateJune 17, 2015

Last NPPES UpdateDecember 8, 20214 updates tracked since enumeration

NPPES CertifiedFebruary 24, 2020

✔ NPI 1609257435 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QS0010X

License✔ Licensed in CA · A015875

Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

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

21634 RETREAT PKWY, Corona, CA 92883

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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 and accepts Medicare assignment

Dr. Poyrung Poysophon Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4486087905

PECOS Enrollment IDI20191213000952

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 92883 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

$91.88 typical visit price

range $59.60 – $179.42

Typical copayment $22.97 (range $14.90 – $44.85)

Most-billed visit code 99203

Established Patient

$104.64 typical visit price

range $19.37 – $146.42

Typical copayment $26.16 (range $4.84 – $36.60)

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.

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