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BOONDARIK SANDY PHUENGSOMBOONYING MD
NPI 1689427403
Student in an Organized Health Care Education/Training Program in Rochester, MI

Active since April 10, 2024PECOS Enrolled
1135 W UNIVERSITY DR STE 250, ROCHESTER, MI 48307(248) 650-6301(248) 650-5486 Get Directions Write a Review

NPPES record last updated: February 11, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 25, 2025, Apr 10, 2024 (2 updates tracked since 2024).

About Boondarik Sandy Phuengsomboonying Md NPPES

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

BOONDARIK SANDY PHUENGSOMBOONYING MD (NPI 1689427403) is an individual student in an organized health care education/training program in Rochester, Michigan and active in the NPI registry since April 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689427403
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameBOONDARIK SANDY PHUENGSOMBOONYINGCredential: MD
Location Address1135 W UNIVERSITY DR STE 250Rochester, MI 48307-1886
Mailing Address1135 W University Dr Ste 250Rochester, MI 48307-1886 · (248) 650-6301 · Fax (248) 601-7637
Phone(248) 650-6301
Fax(248) 650-5486
Sole ProprietorNo
Enumeration DateApril 10, 2024
Last NPPES UpdateFebruary 11, 20262 updates tracked since enumeration
NPPES CertifiedFebruary 11, 2026
✔ NPI 1689427403 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1135 W UNIVERSITY DR STE 250, Rochester, MI 48307
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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 (PECOS)

Boondarik Sandy Phuengsomboonying Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

HEIDI HILTON KOSCH D.O.
Family Medicine
1135 W UNIVERSITY DR STE 250
ROCHESTER, MI 48307
Oakland County (248) 650-6301
ELEANOR KING M.D.
Family Medicine
1135 W UNIVERSITY DR STE 250
ROCHESTER, MI 48307
Oakland County (248) 650-6301
BRANDELYN RACHAEL KELLY MD
Family Medicine
1135 W UNIVERSITY DR STE 250
ROCHESTER HILLS, MI 48307
Oakland County (248) 601-4900
AMNA ZAHIR AL-JAWHER
Student in an Organized Health Care Education/Training Program
1135 W UNIVERSITY DR STE 250
ROCHESTER, MI 48307
Oakland County (248) 650-6301
UDDAMPREET SINGH ARORA
Student in an Organized Health Care Education/Training Program
1135 W UNIVERSITY DR STE 250
ROCHESTER, MI 48307
Oakland County (248) 652-5000
SUSAN AZZARO SIMPSON LLMSW
Social Worker
1135 W UNIVERSITY DR STE 250
ROCHESTER, MI 48307
Oakland County (248) 650-6301
DR. HARDEEP SINGH GARCHA MD
Student in an Organized Health Care Education/Training Program
1135 W UNIVERSITY DR STE 250
ROCHESTER, MI 48307
Oakland County (248) 601-4900
DR. MARIAM SABAH NISSAN MD
Student in an Organized Health Care Education/Training Program
1135 W UNIVERSITY DR STE 250
ROCHESTER, MI 48307
Oakland County (248) 652-5000

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 Boondarik Phuengsomboonying's NPI number?

The NPI number for Boondarik Phuengsomboonying is 1689427403. It was assigned to this individual provider in the NPPES registry on April 10, 2024.

Where is Boondarik Phuengsomboonying located?

Boondarik Phuengsomboonying practices at 1135 W University Dr Ste 250, Rochester, MI 48307. The listed phone number is (248) 650-6301.

What is Boondarik Phuengsomboonying's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Boondarik Phuengsomboonying enrolled in Medicare?

Yes. Boondarik Phuengsomboonying is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Boondarik Phuengsomboonying was last updated on February 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.