Pornchanok Tam Kheocha-on, NP - Medicare Nurse Practitioner in Washington, DC

Pornchanok Tam Kheocha-on, NP is a medicare enrolled "Nurse Practitioner - Family" physician in Washington, District Of Columbia. Her current practice location is 3800 Reservoir Rd Nw, Washington, District Of Columbia. You can reach out to her office (for appointments etc.) via phone at (202) 444-2000.

Pornchanok Tam Kheocha-on is licensed to practice in District Of Columbia (license number NP1041368) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1528770625.

Contact Information

Pornchanok Tam Kheocha-on, NP
3800 Reservoir Rd Nw,
Washington, DC 20007-2113
(202) 444-2000
Not Available



Physician's Profile

Full NamePornchanok Tam Kheocha-on
GenderFemale
SpecialityNurse Practitioner - Family
Location3800 Reservoir Rd Nw, Washington, District Of Columbia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1528770625
  • Provider Enumeration Date: 12/20/2022
  • Last Update Date: 02/22/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 7911370275
  • Enrollment ID: I20230307002042

Medical Identifiers

Medical identifiers for Pornchanok Tam Kheocha-on such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1528770625NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208200000XPlastic Surgery NP1041368 (District Of Columbia)Secondary
363LF0000XNurse Practitioner - Family NP1041368 (District Of Columbia)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Pornchanok Tam Kheocha-on allows following entities to bill medicare on her behalf.
Entity NameMedstar Medical Group Ii Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1184046187
PECOS PAC ID: 0547413825
Enrollment ID: O20130117000415

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Pornchanok Tam Kheocha-on is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Pornchanok Tam Kheocha-on, NP
6291 Hillary Ct,
Alexandria, VA 22315-3440

Ph: () -
Pornchanok Tam Kheocha-on, NP
3800 Reservoir Rd Nw,
Washington, DC 20007-2113

Ph: (202) 444-2000

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