DR. KITTI KAIBORIBOON (M.D.) – Neurology Physician, NPI 1912062035

DR. KITTI KAIBORIBOON (M.D.) is a healthcare provider. based in Salt lake city, Utah. specializing in NEUROLOGY. They hold the professional credentials M.D.. They hold a License No. 35.093501 (OH). The NPI Number for DR. KITTI KAIBORIBOON (M.D.) is 1912062035

Main info

Male
31 Years Of Experience
Accepts Medicare Assignment
Name
DR. KITTI KAIBORIBOON (M.D.)
NPI
1912062035
Phone
(206) 320-4476
Address
PO BOX 25608
Enumeration Date
27 December 2006
Last Update Date
15 June 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2063202000
Graduation Year
1995 (31 years ago)
PAC ID
4284731027
Group Practice PAC ID
0244138196
Professional Enrollment ID
I20150130000742
Address ID
WA981225711SE500XXAVEX300
Telehealth
Yes

Contacts

Secure Messaging
kkaiboriboon983936@wm.providencedirect.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience89
Completeness85
Years active:19State licenses:4Other namesUpdated within 12 months

590 NEUROLOGY in WA

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Provider Addresses for DR. KITTI KAIBORIBOON (M.D.)

  • PO BOX 25608

    SALT LAKE CITY, UT 841250608

    Phone: (206) 320-4476

    Fax: (206) 568-7043

    Type: Mailing

  • James Tower, 550, 17th Avenue, Central District, Seattle, King County, Washington, 98122, United States

    SUITE 540

    SEATTLE, WA 981225788

    Phone: (206) 386-3880

    Fax: (206) 386-3882

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $389.

Total Amount is formed as General ($389) + Research ($0) + Ownership ($0) = $389.

Last reported payment date: 2023-01-20 • Largest payer in this snapshot: Ceribell, Inc. ($389).

Total Amount

$389

General + Research + Ownership

Payments

1

Total payment records

General Amount

$389

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-01-20

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Ceribell, Inc.$389
View all Open Payments →|Open Payments Risk Radar →

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: 2015-01-30

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
I20150130000742INeurologyWATBD

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
G0453Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)18733$0
95937Testing of nerve-muscle junction15949$0
99215Established patient office or other outpatient visit, 40-54 minutes6444$0
95819Measurement of brain wave activity (eeg), awake and asleep6161$0
95938Placement of skin electrodes and measurement of stimulated sites on arms and legs6060$0
View full utilization report →

Insurance plans in this area (ZIP 84125)

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Provider's Procedures

DR. KITTI KAIBORIBOON (M.D.) performs procedures in NEUROLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
NEUROLOGYWA95819Measurement and recording of brain wave (EEG) activity, awake and asleep3939

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: 0244138196View full group profile
NameSpecialtyState
-WA
General SurgeryWA
Orthopedic SurgeryWA
P S Y C H I A T R YWA
Hospitalist, Hospice/Palliative Care, Internal MedicineWA
Hospitalist, Hospice/Palliative CareWA
Physician AssistantWA
N E U R O L O G YWA
N E U R O L O G YWA
Hospitalist, Hospice/Palliative Care, Internal MedicineND

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Frequently asked questions

What number should I use to identify DR. KITTI KAIBORIBOON (M.D.) for billing?
Administrative and clinical systems typically use NPI 1912062035 for DR. KITTI KAIBORIBOON (M.D.).
Is DR. KITTI KAIBORIBOON (M.D.) currently accepting referrals based on NPI status?
Registry metadata lists DR. KITTI KAIBORIBOON (M.D.) as active.
What services align with DR. KITTI KAIBORIBOON (M.D.)'s listing?
DR. KITTI KAIBORIBOON (M.D.)'s public classification highlights Neurology Physician. Clinical services aligned with this taxonomy classification.
Is DR. KITTI KAIBORIBOON (M.D.) tied to Salt Lake City, Utah?
If you are local to Salt Lake City, Utah, DR. KITTI KAIBORIBOON (M.D.) may be relevant to your search.
Why is information missing for DR. KITTI KAIBORIBOON (M.D.)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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