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

Mr. Parkpoom Phatharacharukul, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1205254547

Mr. Parkpoom Phatharacharukul, MD is a Gastroenterology in St Louis Park, Minnesota. Qualified in 2011, 15 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, works from 4 locations, accepts Medicare assignment and offers telehealth. Licensed in Minnesota and South Dakota.

Years since qualifying
15
Licensed in
MN, SD
In the registry since
2014
Specialties on file
3
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

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone: (952) 993-3240
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 702 Rotary Cir Ste 225, Indianapolis, IN 46202-5133 — (317) 278-4427
  • 420 Delaware St Se, Minneapolis, MN 55455-0341 — (612) 626-5031
  • 1205 S Grange Ave Ste 510, Sioux Falls, SD 57105-0410 — (605) 328-8500

Specialties & licences

Gastroenterology Physician (primary) Taxonomy 207RG0100X · Licence 72751 (MN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Gastroenterology Physician Taxonomy 207RG0100X · Licence 11709 (SD)

Record details

NPI number1205254547
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 3, 2014
Last updated in NPPESOctober 20, 2023
Certification dateOctober 20, 2023

Medicare enrollment

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

Medicare specialtyGASTROENTEROLOGY
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in St Louis Park