Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Chanika Phornphutkul, MD

Individual provider Pediatric Endocrinology Physician · NPI 1639124530

Chanika Phornphutkul, MD is a Pediatric Medicine in Providence, Rhode Island. Qualified in 1992, 34 years ago. Practices with Rhode Island Hospital, a 428-clinician group and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
34
Licensed in
RI
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

593 Eddy St
Providence, RI 02903-4923
Phone: (401) 444-8361
Fax: (401) 444-3288
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Biochemical Genetics Physician (primary) Taxonomy 207SG0202X · Licence MD10121 (RI)
Pediatric Endocrinology Physician Taxonomy 2080P0205X · Licence 10121 (RI)

Record details

NPI number1639124530
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 23, 2006
Last updated in NPPESDecember 21, 2011

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolOTHER
Graduated 1992 (34 years in practice)
Group practice Rhode Island Hospital — 428 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Providence