DR. PUMIPAK TANTAMJARIK (MD, FAAFP) – Family Medicine Physician, NPI 1891789566
Family Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. PUMIPAK TANTAMJARIK (MD, FAAFP)
12555, Garden Grove Boulevard, Garden Grove, Orange County, California, 92843, United States
STE 504
GARDEN GROVE, CA 928431903
Phone: (714) 537-5609
Fax: (714) 530-0744
Type: Mailing
1610 W EDINGER AVE STE B
SANTA ANA, CA 927044339
Phone: (714) 641-1610
Fax: (714) 641-1146
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $62.
Total Amount is formed as General ($62) + Research ($0) + Ownership ($0) = $62.
Last reported payment date: 2024-09-05 • Largest payer in this snapshot: Lilly USA, LLC ($25).
Total Amount
$62
General + Research + Ownership
Payments
3
Total payment records
General Amount
$62
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $25 |
| LINUS HEALTH, INC. | $19 |
| Merck Sharp & Dohme LLC | $17 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2005-03-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050321001001 | I | Family Practice | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 92843)
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