Patchawan Phunwutikorn, PSYD
NPI 1114455706ActiveIndividual· Psychologist· Grand Blanc, MI
Psychologist (PSYD) with Henry Ford Health Genesys Hospital and 1 other group, practicing in Grand Blanc, Michigan. Medicare paid $6,733 for services to 36 patients in 2024. Lists Ascension Genesys Hospital as a hospital affiliation.
Overview
| NPI | 1114455706 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PSYD |
| Sole proprietor | Yes |
| NPI issued | May 26, 2017 |
| Last updated in NPPES | Aug 17, 2022 |
| Certified by provider | Aug 17, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (MI); Practitioner - Clinical Psychologist (VA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 36 |
|---|---|
| Services billed | 130 across 7 procedure codes |
| Paid by Medicare | $6,733 |
Education and affiliations
| Graduation year | 2020 |
|---|---|
| Medicare specialty | Clinical Psychologist |
| Telehealth | Offers telehealth |
Medical groups
- Henry Ford Health Genesys HospitalGrand Blanc, MI · 84 clinicians
- Assessment and Therapy AssociatesChesapeake, VA · 21 clinicians
Hospital affiliation
- Ascension Genesys HospitalGrand Blanc, MI
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