KONGSAK CHANTORNSAENG (M.D.) – Family Medicine Physician, NPI 1942250659
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
12,368 INTERNAL MEDICINE in FL
Provider Addresses for KONGSAK CHANTORNSAENG (M.D.)
403 E 11TH ST
PANAMA CITY, FL 324013409
Phone: (185) 074-7559
Fax: (850) 279-6771
Type: Location
4126 Independent Drive
PANAMA CITY, FL 324487993
Phone: (850) 394-4907
Type: Location
403, East 11th Street, Glenwood, Panama City, Bay County, Florida, 32401, United States
PANAMA CITY, FL 324013409
Phone: (185) 074-7559
Fax: (850) 279-6771
Type: Mailing
Florida Department of Health in Jackson County, 4979, Healthy Way, Marianna, Jackson County, Florida, 32446, United States
MARIANNA, FL 324467993
Phone: (850) 526-2412
Type: Location
4126 INDEPENDENT DRIVE
PANAMA CITY, FL 324487993
Phone: (850) 394-4907
Type: Location
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: 2004-03-25
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 |
|---|---|---|---|---|
| I20040325000266 | I | Internal Medicine | FL | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 38 | 32 | $0 |
| G0008 | Administration of influenza virus vaccine | 24 | 24 | $0 |
| 90662 | Influenza vaccine split virus, preservative free | 22 | 22 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 18 | 18 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 12 | 12 | $0 |
Insurance plans in this area (ZIP 32401)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | FL | |
| Nurse Practitioner | FL | |
| Clinical Social Worker | FL | |
| - | FL | |
| Physician Assistant | FL | |
| General Practice, Family Practice | FL | |
| Clinical Social Worker | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| General Practice | FL |
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