Doctor profile · Federal record

Dr. Chanika Phornphutkul, MD

Clinical Biochemical Genetics Physician (CMS: Pediatric Medicine) · Pediatric Endocrinology Physician · Providence, RI

  • NPI 1639124530
  • Accepts Medicare
  • 34 yrs in practice
  • Female
  • Group practice
  • No sanctions

Practice & contact

NPPES Updated May 11, 2026
Primary practice
593 Eddy St
Providence, RI 029034923
(401) 444-8361
fax (401) 444-3288

Credentials & registration

NPPES · NUCC
NPI registered
May 2006 — 20 yrs on file
Profile last updated
December 21, 2011
Year of graduation
1992 — 34 yrs since
Specialty taxonomy
207SG0202X — NUCC code
State licenses (2)
Rhode Island #MD10121 · Rhode Island #10121
Medicaid
RI #CP46587

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1639124530. Last verified May 11, 2026.

Medicare procedures · 2023

Top services delivered

CMS Provider Utilization
Total services
16
Distinct HCPCS
1
Medicare allowed
$2,150
HCPCS Description Services Patients Avg allowed
99204 New patient office or other outpatient visit, 45-59 minutes 16 16 $134

In context: peer comparison

Among 1 peers in Providence Clinical Biochemical Genetics Physician, average services per provider: 16. This provider delivers 1.0× the peer median.

Medicare Part D · 2023

Top prescriptions

CMS Part D Prescriber
Total claims
16
Patients
0
Total drug cost
$324,438
Drug Type Claims Patients Total cost
Buphenyl (Sodium Phenylbutyrate) Brand 16 0 $324,438

Hospital affiliations

CMS Hospital Compare

Frequently asked questions

Auto-generated from federal data
What is Dr. Chanika Phornphutkul's medical specialty?
Dr. Chanika Phornphutkul practices Clinical Biochemical Genetics Physician in Providence, RI.
Where does Dr. Chanika Phornphutkul practice?
Dr. Chanika Phornphutkul practices at 593 Eddy St, Providence, RI 029034923. Office phone: 4014448361.
What is Dr. Chanika Phornphutkul's NPI?
Dr. Chanika Phornphutkul's National Provider Identifier (NPI) is 1639124530, issued by NPPES.
Does Dr. Chanika Phornphutkul accept Medicare assignment?
Yes. Dr. Chanika Phornphutkul accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Chanika Phornphutkul commonly perform?
Top Medicare-reported procedures in 2023: New patient office or other outpatient visit (HCPCS 99204). Source: CMS Medicare Physician & Other Practitioners file.