Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1114455706 Individual Practitioner Female Practitioner

Dr. Patchawan Phunwutikorn , PsyD

Psychologist • Grand Blanc, MI

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Patchawan Phunwutikorn, PsyD is a certified Psychologist practicing in Grand Blanc, MI. With approximately 6 years of clinical experience since completing medical education in 2020, Dr. Phunwutikorn delivers high-quality medical care to the local community at 1 GENESYS PKWY.

Dr. Phunwutikorn maintains professional affiliations with Henry Ford Health Genesys Hospital, Assessment And Therapy Associates and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include administration of psychological or neuropsychological test, psychiatric diagnostic evaluation, evaluation of psychological test, first hour. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1 Genesys Pkwy

Grand Blanc, MI 484398065

Telephone 8106065126
Associated Practice Facility / Clinic
🏢 Statcare Pc Facility NPI 1255333498

Medicare Profile & Education

Medical School

Other

Graduation Year

2020

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Grand Blanc, MI

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
6 Yrs -21.0 yrs vs City Avg
City Avg: 27.0 Yrs
State Avg: 26.4 Yrs
Regional Practice Density
12 Specialists

Practicing in Grand Blanc, MI (2669 Statewide)

Telehealth Adoption Rate
16.7% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount
60.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Phunwutikorn (6 Years) 6 Yrs
Grand Blanc Specialty Average (27.0 Years) 27.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
96137 Administration of psychological or neuropsychological test, each additional 30 minutes
39 13 $150.00 $15.91
90791 Psychiatric diagnostic evaluation
19 18 $195.00 $143.50
90791 Psychiatric diagnostic evaluation
13 13 $300.00 $134.39
96130 Evaluation of psychological test, first hour
13 13 $250.00 $96.88
96136 Administration of psychological or neuropsychological test, first 30 minutes
13 13 $150.00 $20.64

Medical Specialties & State Licenses

CMS Verified: 2022-08-17
Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
8121 (CA)

Hospital & Practice Group Affiliations

Henry Ford Health Genesys Hospital

1 Genesys Pkwy, Grand Blanc, MI 484398065

Phone: 8106065000

Assessment And Therapy Associates

1545 Crossways Blvd, Chesapeake, VA 233200218

Phone: 7572062772

Secondary Practice Locations

2325 Clement Ave Ste A

Alameda, CA 945017061

Phone: 5106296367

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
Jeffrey Sobecki

Internal Medicine - Gastroenterology

NPI 1245779099
Dr. Jennifer Bakar , MD

Emergency Medicine

NPI 1467864488

Doctor of Medicine (M.D.)

Dr. Tamara Ivers , MD

Internal Medicine - Cardiovascular Disease

NPI 1538691209

Doctor of Medicine (M.D.)

Dr. Allison Keel , DO

Internal Medicine

NPI 1629411921

Doctor of Osteopathic Medicine (D.O.)

NPI 1679952196

Doctor of Medicine (M.D.)

Dylan Mooney

Family Medicine

NPI 1710335641

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 17, 2022

Psychologist

📍
Updated Practice Location August 17, 2020

Registered at 1 GENESYS PKWY, GRAND BLANC, MI 484398065 (Tel: 8106065126)

📍
Updated Business Mailing Address August 17, 2020

Registered at 2004 FOX HILL DR APT 1, GRAND BLANC, MI 484395244

👤
Provider Name / Credentials Updated August 17, 2020

Recorded as PATCHAWAN PHUNWUTIKORN, PSYD

NPI Profile Active May 26, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location May 26, 2017

Registered at 2325 CLEMENT AVE STE A, ALAMEDA, CA 945017061 (Tel: 5106296367)

📍
Updated Business Mailing Address May 26, 2017

Registered at 2325 CLEMENT AVE STE A, ALAMEDA, CA 945017061

👤
Provider Name / Credentials Updated May 26, 2017

Recorded as PATCHAWAN PHUNWUTIKORN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 26, 2017

Counselor

🟢
Initial NPI Registration & Enumeration May 26, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114455706
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 26, 2017
Last Update: August 17, 2022
Sole Proprietor: Yes

Mailing Address

2004 Fox Hill Dr Apt 1

Grand Blanc, MI 484395244

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.