KIMMIE PHISAIWATH APRN-CNP
NPI 1639662216
Nurse Practitioner - Family in Oklahoma City, OK

Q: What is Kimmie Phisaiwath's NPI number?

The NPI number for Kimmie Phisaiwath is 1639662216. It was assigned to this individual provider in the NPPES registry on June 8, 2018. The provider is also known as Phuong Nguyen.

Q: What is Kimmie Phisaiwath's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Kimmie Phisaiwath was last updated on November 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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 08, 2018PECOS EnrolledAccepts Medicare Assignment

4050 W MEMORIAL RD FL 3, OKLAHOMA CITY, OK 73120(405) 608-3855 Get Directions Write a Review

NPPES record last updated: November 15, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 15, 2024, Jun 12, 2020 (2 updates tracked since 2020).

On this page

About Kimmie Phisaiwath Aprn-cnp NPPES

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

KIMMIE PHISAIWATH APRN-CNP (NPI 1639662216) is an individual family provider in Oklahoma City, Oklahoma, licensed in Oklahoma (R009993) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1639662216

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameKIMMIE PHISAIWATHCredential: APRN-CNP

Location Address4050 W MEMORIAL RD FL 3Oklahoma City, OK 73120-8382

Mailing Address7800 Nw 85th TerOklahoma City, OK 73132-3385

Phone(405) 608-3855

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateJune 8, 2018

Last NPPES UpdateNovember 15, 20242 updates tracked since enumeration

NPPES CertifiedNovember 15, 2024

✔ NPI 1639662216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in OK · R009993

4050 W MEMORIAL RD FL 3, Oklahoma City, OK 73120

Open in Google Maps ↗

Other Names 1

Former Name (1)Phuong Nguyen

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and more.Insurance ›

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

Kimmie Phisaiwath Aprn-cnp 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 ID3375894124

PECOS Enrollment IDI20180918003751

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

Medicare enrollment records show Kimmie Phisaiwath reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ohh Physicians, LLC

Same address

Cardiovascular Disease

4050 W MEMORIAL RD
Oklahoma City, OK 73120

Reassigned Medicare billing, Oklahoma enrollment
125 clinicians in this Medicare group

NPI 1023087772 (405) 608-3800

Diabetic Foot And Wound Center Of Okfas

1.9 mi

Foot & Ankle Surgery

11100 HEFNER POINTE DRIVE, SUITE A
Oklahoma City, OK 73120

Reassigned Medicare billing, Oklahoma enrollment
3 clinicians in this Medicare group

NPI 1780171009 (405) 691-9004

Provider Profile

16 mi

Podiatrist

9315 S PENNSYLVANIA AVE STE A
Oklahoma City, OK 73159

Reassigned Medicare billing, Oklahoma enrollment
2 clinicians in this Medicare group

NPI 1962566307 (405) 691-9004

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 9

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.

Removal of fingernails or toenails, 6 or more nails 11721

This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.

149 services92 patients

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

68 services37 patients

X-ray of ankle, minimum of 3 views 73610

An ankle X-ray is a quick, painless imaging test. It involves capturing at least three different images or 'views' of your ankle using small amounts of radiation. These images help identify any abnormalities or injuries, such as fractures or arthritis.

65 services34 patients

Ultrasound study of arm and leg arteries 93922

An ultrasound study of arm and leg arteries is a non-invasive procedure that uses sound waves to create images of your arteries. It helps in checking blood flow, identifying blockages, or detecting other abnormalities in your arteries.

35 services34 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

34 services27 patients

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

32 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 73120 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

$82.46 typical visit price

range $53.00 – $162.61

Typical copayment $20.61 (range $13.25 – $40.65)

Most-billed visit code 99203

Established Patient

$94.27 typical visit price

range $16.68 – $132.40

Typical copayment $23.56 (range $4.17 – $33.10)

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.

VARUN KHANNA M.D.

Internal Medicine (Cardiovascular Disease)