DR. PONGCHANOK PAKDEESUPAPOL M.D.
NPI 1679992325
Internal Medicine in Las Vegas, NV

Q: What is Pongchanok Pakdeesupapol's NPI number?

The NPI number for Pongchanok Pakdeesupapol is 1679992325. It was assigned to this individual provider in the NPPES registry on April 9, 2014.

Q: What is Pongchanok Pakdeesupapol's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since April 09, 2014PECOS EnrolledAccepts Medicare Assignment

6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113(702) 952-9171(702) 952-9170 Get Directions Write a Review

NPPES record last updated: November 1, 2022. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Nov 1, 2022, Jul 21, 2022, Jul 25, 2017 and 1 more (4 updates tracked since 2017).

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About Dr. Pongchanok Pakdeesupapol M.d. NPPES

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

DR. PONGCHANOK PAKDEESUPAPOL M.D. (NPI 1679992325) is an individual internal medicine provider in Las Vegas, Nevada, licensed in Nevada (17040) and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS, is affiliated with University Medical Center, and maintains a secondary practice location in Las Vegas.

NPPES Registry Identity

NPI1679992325

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. PONGCHANOK PAKDEESUPAPOLCredential: M.D.

Location Address6355 S BUFFALO DR FL 3Las Vegas, NV 89113-2133

Mailing Address6355 S Buffalo Dr Fl 3Las Vegas, NV 89113-2133 · (702) 216-3346 · Fax (702) 671-6883

Phone(702) 952-9171

Fax(702) 952-9170

Sole ProprietorNo

Medical School CMSUniversity Of Nevada School Of MedicineGraduated 2014

Enumeration DateApril 9, 2014

Last NPPES UpdateNovember 1, 20224 updates tracked since enumeration

NPPES CertifiedNovember 1, 2022

✔ NPI 1679992325 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in NV · 17040✔ Licensed in CA · A140027

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

6355 S BUFFALO DR FL 3, Las Vegas, NV 89113

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Secondary Practice Location 1

Location 11000 S Rainbow BlvdLas Vegas, NV 89145-6231 · Phone (702) 952-9171 · Fax (702) 952-9136

Other Identifiers 2

Medicaid1679992325NV

OtherPENDINGNV · Medicare Pin

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health.Insurance ›

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. Pongchanok Pakdeesupapol M.d. 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 ID4688947005

PECOS Enrollment IDI20170907000736

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.

Hospital Affiliations CMS Care Compare

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

University Medical Center

Acute Care Hospitals · Las Vegas, NV

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number290007

Location1800 W Charleston BlvdLas Vegas, NV 89102 · Clark County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89113 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

$131.25 typical visit price

range $57.07 – $173.24

Typical copayment $32.81 (range $14.26 – $43.31)

Most-billed visit code 99204

Established Patient

$100.60 typical visit price

range $18.27 – $140.96

Typical copayment $25.15 (range $4.56 – $35.24)

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.

NITTU SINGH MD

Family Medicine