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BOONTHARICK SOPONTAMMARAK DO
NPI 1851090252
Internal Medicine in Jbsa Ft Sam Houston, TX

Active since February 24, 2023PECOS Enrolled
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234(210) 292-7805(210) 292-7868 Get Directions Write a Review

NPPES record last updated: June 7, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 7, 2026, Nov 23, 2024, Aug 13, 2023 and 2 more (5 updates tracked since 2023).

About Boontharick Sopontammarak Do NPPES

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

BOONTHARICK SOPONTAMMARAK DO (NPI 1851090252) is an individual internal medicine provider in Jbsa Ft Sam Houston, Texas, licensed in Virginia (0102208949) and active in the NPI registry since February 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1851090252
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameBOONTHARICK SOPONTAMMARAKCredential: DO
Location Address3551 ROGER BROOKE DRJbsa Ft Sam Houston, TX 78234-4504
Mailing Address3551 Roger Brooke DrJbsa Ft Sam Houston, TX 78234-4504
Phone(210) 292-7805
Fax(210) 292-7868
Sole ProprietorNo
Enumeration DateFebruary 24, 2023
Last NPPES UpdateJune 7, 20265 updates tracked since enumeration
NPPES CertifiedJune 7, 2026
✔ NPI 1851090252 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in VA · 0102208949
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.
Also ListedMilitary Health Care ProviderTaxonomy 171000000X
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3551 ROGER BROOKE DR, Jbsa Ft Sam Houston, TX 78234
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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)

Boontharick Sopontammarak Do 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78234 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

JANET JONES SIMS CRNA
Nurse Anesthetist, Certified Registered
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Bexar County (253) 223-6272
JAMES KENNEDY HARDIN PA-C
Physician Assistant
3551 ROGER BROOKE DR
JBSA FT SAM HOUSTON, TX 78234
Bexar County (210) 295-4996
DR. DANIEL VICTOR-CALVIN HAMMOND M.D.
Pediatrics (Pediatric Endocrinology)
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Bexar County (210) 916-3020
JESSICA FULLER LCSW
Social Worker (Clinical)
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Bexar County (210) 808-1859
DR. JASON ROBERT HALL M.D.
Neurological Surgery
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Bexar County (210) 539-9582
MRS. KATHRYN ELAINE HELLAND LCSW
Social Worker (Clinical)
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Bexar County (210) 539-9582
DR. HALWARD BLEGEN IV DO
Ophthalmology
3551 ROGER BROOKE DR
JBSA FORT SAM HOUSTON, TX 78234
Bexar County (210) 220-7419
KOLE HOLLAND SPAULDING M.D.
Emergency Medicine (Emergency Medical Services)
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Bexar County (210) 539-9582

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 Boontharick Sopontammarak's NPI number?

The NPI number for Boontharick Sopontammarak is 1851090252. It was assigned to this individual provider in the NPPES registry on February 24, 2023.

Where is Boontharick Sopontammarak located?

Boontharick Sopontammarak practices at 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234. The listed phone number is (210) 292-7805.

What is Boontharick Sopontammarak's specialty?

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

Is Boontharick Sopontammarak enrolled in Medicare?

Yes. Boontharick Sopontammarak is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Boontharick Sopontammarak was last updated on June 7, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.