DR. TONY SANGCHOMPUPHEN (MD) – Diagnostic Radiology Physician, NPI 1104826916

DR. TONY SANGCHOMPUPHEN (MD) is a healthcare provider. based in Aurora, Colorado. specializing in DIAGNOSTIC RADIOLOGY. They hold the professional credentials MD. They hold a License No. 35081743 (OH). The NPI Number for DR. TONY SANGCHOMPUPHEN (MD) is 1104826916

Main info

Male
29 Years Of Experience
Accepts Medicare Assignment
Name
DR. TONY SANGCHOMPUPHEN (MD)
NPI
1104826916
Phone
(303) 338-4545
Address
2500 S HAVANA ST
Enumeration Date
22 July 2005
Last Update Date
20 April 2021

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
Secondary Phone
3033384545
Graduation Year
1997 (29 years ago)
PAC ID
2668371147
Group Practice PAC ID
1254238454
Professional Enrollment ID
I20090309000105
Address ID
CO802055437DE2045XSTXX401

Contacts

SOAP Endpoint
https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience82
Completeness85
Years active:20State licenses:3Other namesUpdated within 12 months

927 DIAGNOSTIC RADIOLOGY in CO

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Provider Addresses for DR. TONY SANGCHOMPUPHEN (MD)

  • Kaiser Permanente, 2500, South Havana Street, Aurora, Arapahoe County, Colorado, 80014, United States

    AURORA, CO 800141618

    Phone: (303) 338-4545

    Type: Mailing

  • 2045, Franklin Street, City Park West, Denver, Denver County, Colorado, 80205, United States

    DENVER, CO 802055437

    Phone: (303) 338-4545

    Type: Location

  • 10350 E DAKOTA AVE

    DENVER, CO 802471314

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2009-03-09

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090309000105IDiagnostic RadiologyCOTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
77067Screening mammography1616$0
77063Screening 3d breast mammography1414$0
View full utilization report →

Insurance plans in this area (ZIP 80014)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1254238454View full group profile
NameSpecialtyState
Nurse PractitionerCO
-CO
Physical Therapist In Private PracticeCO
-CO
-CO
-CO
Cardiovascular Disease (Cardiology)CO
Physical Therapist In Private PracticeCO
Physical Therapist In Private PracticeCO
Family PracticeCO

Reviews

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Frequently asked questions

What federal number belongs to DR. TONY SANGCHOMPUPHEN (MD)?
The federal identifier for DR. TONY SANGCHOMPUPHEN (MD) is NPI 1104826916.
Is DR. TONY SANGCHOMPUPHEN (MD)'s NPI currently valid?
The extract we use shows DR. TONY SANGCHOMPUPHEN (MD) as active.
Does DR. TONY SANGCHOMPUPHEN (MD) list a primary specialty?
If you are matching referrals, note Diagnostic Radiology Physician for DR. TONY SANGCHOMPUPHEN (MD). Clinical services aligned with this taxonomy classification.
Where does public data place DR. TONY SANGCHOMPUPHEN (MD)?
The snapshot lists Aurora, Colorado for DR. TONY SANGCHOMPUPHEN (MD); download NPPES for the complete set.
How can I contact DR. TONY SANGCHOMPUPHEN (MD)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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