WORAWAN RATTANASAMPHAN (MD) – Specialist, NPI 1073574471
Specialist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
107 GERIATRIC MEDICINE in WA
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Provider Addresses for WORAWAN RATTANASAMPHAN (MD)
112th Ave NE & NE 19 St, 112th Avenue Northeast, Ashwood, Bellevue, King County, Washington, 98004, United States
SUITE A-101
BELLEVUE, WA 98008
Phone: (425) 688-5234
Fax: (425) 688-5756
Type: Mailing
1750, 112th Avenue Northeast, Ashwood, Bellevue, King County, Washington, 98004, United States
SUITE A-101
BELLEVUE, WA 980043752
Phone: (425) 688-5234
Fax: (425) 688-5756
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $254.
Total Amount is formed as General ($254) + Research ($0) + Ownership ($0) = $254.
Last reported payment date: 2024-10-17 • Largest payer in this snapshot: Phathom Pharmaceuticals, Inc. ($129).
Total Amount
$254
General + Research + Ownership
Payments
2
Total payment records
General Amount
$254
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Phathom Pharmaceuticals, Inc. | $129 |
| GlaxoSmithKline, LLC. | $125 |
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: 2010-06-30
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100630000196 | I | Geriatric Medicine | WA | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 1,229 | 562 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 314 | 314 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 112 | 102 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 66 | 66 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 65 | 64 | $0 |
Insurance plans in this area (ZIP 98008)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| GERIATRIC MEDICINE | WA | 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 43 | 40 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | MA | |
| Internal Medicine | VA | |
| Family Practice | GA | |
| Orthopedic Surgery | IL | |
| - | NC | |
| - | TX | |
| Internal Medicine | MA | |
| Family Practice | OR | |
| Nurse Practitioner | WA | |
| Internal Medicine | MA |
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