1. Home
  2. Directory
  3. Rhode Island
  4. Providence
  5. Medical Genetics
  6. NPI Profile

CHANIKA PHORNPHUTKUL MD
NPI 1639124530
Medical Genetics - Clinical Biochemical Genetics in Providence, RI

Active since May 23, 2006PECOS EnrolledAccepts Medicare Assignment
593 EDDY ST, PROVIDENCE, RI 02903(401) 444-8361(401) 444-3288 Get Directions Write a Review

NPPES record last updated: December 21, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Chanika Phornphutkul Md NPPES

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

CHANIKA PHORNPHUTKUL MD (NPI 1639124530) is an individual clinical biochemical genetics provider in Providence, Rhode Island, licensed in Rhode Island (MD10121) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with Rhode Island Hospital, and is a graduate of Other (1992).

NPPES Registry Identity

NPI1639124530
Entity TypeIndividualFemale
Primary Taxonomy207SG0202X
Provider Legal NameCHANIKA PHORNPHUTKULCredential: MD
Location Address593 EDDY STProvidence, RI 02903-4923
Mailing Address593 Eddy St, Hasbro 122Providence, RI 02903-4923 · (401) 444-8361 · Fax (401) 444-3288
Phone(401) 444-8361
Fax(401) 444-3288
Sole ProprietorNo
Medical School CMSOtherGraduated 1992
Enumeration DateMay 23, 2006
Last NPPES UpdateDecember 21, 2011
✔ NPI 1639124530 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyMedical Genetics · Clinical Biochemical GeneticsAllopathic & Osteopathic Physicians
Taxonomy Code207SG0202X
License✔ Licensed in RI · MD10121
Definition
A clinical biochemical geneticist demonstrates competence in performing and interpreting biochemical analyses relevant to the diagnosis and management of human genetic diseases and is a consultant regarding laboratory diagnosis of a broad range of inherited disorders.
Also ListedPediatrics · Pediatric EndocrinologyTaxonomy 2080P0205X · License 10121 (RI)
593 EDDY ST, Providence, RI 02903
Open in Google Maps ↗

Other Identifiers 3

MedicaidCP46587RI
Medicare UPINH71415RI
Medicare PIN007010049RI

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

Chanika Phornphutkul 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 ID2668486754
PECOS Enrollment IDI20130403000436
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 Reassignments

4

Medicare enrollment records show Chanika Phornphutkul reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lifespan Physician Group, Inc.
Same address
General Practice
593 EDDY ST
Providence, RI 02903
  • Reassigned Medicare billing, Rhode Island enrollment
  • 1,372 clinicians in this Medicare group
NPI 1407116643 (401) 444-6779
Rhode Island Hospital
Same address
Hematology & Oncology
593 EDDY ST
Providence, RI 02903
  • Reassigned Medicare billing, Rhode Island enrollment
  • Also billed through NPI 1861420333 (Rhode Island)
  • 182 clinicians in this Medicare group
NPI 1396849782 (401) 444-5291
Affinity Physicians LLC
0.2 mi
Anesthesiology
101 DUDLEY STREET, WIH DEPT OF ANESTHESIOLOGY
Providence, RI 02905
  • Reassigned Medicare billing, Rhode Island enrollment
  • 984 clinicians in this Medicare group
NPI 1053038471 (401) 274-1122
The Miriam Hospital
2.2 mi
Multi-Specialty
146 W RIVER ST
Providence, RI 02904
  • Reassigned Medicare billing, Rhode Island enrollment
  • 53 clinicians in this Medicare group
NPI 1164716031 (401) 793-3215

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
31 services31 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Rhode Island Hospital

Acute Care Hospitals · Providence, RI
3/5 CMS rating
OwnershipTribal
CMS Certification Number410007
Location593 Eddy StreetProvidence, RI 02903 · Providence County
Emergency services

The Miriam Hospital

Acute Care Hospitals · Providence, RI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number410012
Location164 Summit AvenueProvidence, RI 02906 · Providence County
Emergency services

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. KEITH-AUSTIN SCARFO D.O.
Anesthesiology
593 EDDY ST, APC 6
PROVIDENCE, RI 02903
Providence County (401) 444-3777
AILEEN HSUEH
Surgery
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-8450
RHODE ISLAND HOSPITAL
General Acute Care Hospital
593 EDDY ST, MAIN 4
PROVIDENCE, RI 02903
Providence County (401) 444-7585
DR. GA HIE NAM M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-5057
EUGENIE ATALLAH
Psychiatry & Neurology (Neurology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 606-2645
BRET CAULFIELD
Physician Assistant
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4000
JUNG HO GONG
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 793-2695
FANNY HUANG MD
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4741

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 Chanika Phornphutkul's NPI number?

The NPI number for Chanika Phornphutkul is 1639124530. It was assigned to this individual provider in the NPPES registry on May 23, 2006.

Where is Chanika Phornphutkul located?

Chanika Phornphutkul practices at 593 Eddy St, Providence, RI 02903. The listed phone number is (401) 444-8361.

What is Chanika Phornphutkul's specialty?

The primary specialty registered for this NPI is Medical Genetics, specializing in Clinical Biochemical Genetics, with taxonomy code 207SG0202X.

Is Chanika Phornphutkul enrolled in Medicare?

Yes. Chanika Phornphutkul 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 Chanika Phornphutkul's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Chanika Phornphutkul reassigns Medicare benefits to 4 organizations: Lifespan Physician Group, Inc. (Providence, RI), Rhode Island Hospital (Providence, RI), Affinity Physicians LLC (Providence, RI) and The Miriam Hospital (Providence, RI). 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 Chanika Phornphutkul's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Chanika Phornphutkul affiliated with any hospitals?

According to CMS data, Chanika Phornphutkul is affiliated with Rhode Island Hospital and The Miriam Hospital.

When was this NPI record last updated?

The NPPES record for Chanika Phornphutkul was last updated on December 21, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.