DR. POYRUNG POYSOPHON MD
NPI 1609257435
Family Medicine - Sports Medicine in Corona, CA
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, maintains 4 additional practice locations, and is a graduate of Other (2015).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 4
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignments
2Medicare enrollment records show Poyrung Poysophon reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Riverside, CA 92505
- Reassigned Medicare billing, California enrollment
- 5,228 clinicians in this Medicare group
Riverside, CA 92506
- Reassigned Medicare billing, California enrollment
- 349 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 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.
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.
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 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.
Where is Poyrung Poysophon located?
Poyrung Poysophon practices at 21634 Retreat Pkwy, Corona, CA 92883. The listed phone number is (951) 493-6832.
What is Poyrung Poysophon's specialty?
The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.
Is Poyrung Poysophon enrolled in Medicare?
Yes. Poyrung Poysophon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Poyrung Poysophon's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Poyrung Poysophon reassigns Medicare benefits to 2 organizations: Southern California Permanente Medical Group (Riverside, CA) and Riverside Medical Clinic, Inc (Riverside, 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 Poyrung Poysophon'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 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.
# Dr. Poyrung Poysophon, MD · NPI 1609257435
Sports Medicine physician in Corona, California. Individual provider, active in the CMS NPPES registry since June 17, 2015.
## Identity
- **NPI:** 1609257435 (Entity type: Individual)
- **Enumerated:** June 17, 2015
- **Primary specialty:** Family Medicine - Sports Medicine · taxonomy 207QS0010X
- **State license:** A015875 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 21634 RETREAT PKWY, Corona, CA 92883-6100
- **Phone:** (951) 493-6832
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **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): Southern California Permanente Medical Group (NPI 1316979834, Riverside, CA); Riverside Medical Clinic, Inc (NPI 1730180415, Riverside, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2015
## Record status
- **NPPES last updated:** December 8, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1609257435) · Data from the CMS NPPES public registry.