Porntawee Aphivantrakul
NPI 1124814785ActiveIndividual· Internal Medicine· Great Falls, MT
Internal Medicine in Great Falls, Montana, licensed in WI and MT, with an NPI issued in April 2025. Enrolled in Medicare as order and referring only - internal medicine.
Overview
| NPI | 1124814785 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Apr 18, 2025 |
| Last updated in NPPES | Sep 17, 2026 |
| Certified by provider | Sep 17, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | 102679-851 | WI |
| Internal Medicine | 207R00000X | MED-RES-LIC-159291 | MT |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | — |
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 Order and Referring Only - Internal Medicine (MT) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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