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Active NPI 1154852705 Individual Practitioner Male Practitioner

Thanapoom Boonipat

Plastic Surgery • Fort Worth, TX

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Thanapoom Boonipat is a certified Plastic Surgery practicing in Fort Worth, TX. With approximately 9 years of clinical experience since completing medical education in 2017, Thanapoom Boonipat delivers high-quality medical care to the local community at 1500 S MAIN ST.

Thanapoom Boonipat accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

1500 S Main St

Fort Worth, TX 761044917

Telephone 8177021100
Associated Practice Facility / Clinic
🏢 Jps Physician Group Inc Facility NPI 1184619082

Medicare Profile & Education

Medical School

Other

Graduation Year

2017

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Plastic Surgery in Fort Worth, TX

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
9 Yrs -15.7 yrs vs City Avg
City Avg: 24.7 Yrs
State Avg: 29.2 Yrs
Regional Practice Density
17 Specialists

Practicing in Fort Worth, TX (399 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Boonipat (9 Years) 9 Yrs
Fort Worth Specialty Average (24.7 Years) 24.7 Yrs

Medical Specialties & State Licenses

CMS Verified: 2024-12-20
Plastic Surgery Primary Specialty

NUCC Taxonomy Code: 208200000X

State License TX U9214

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

Plastic Surgery

NUCC Taxonomy Code: 208200000X

State License MN 28451

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

Plastic Surgery

NUCC Taxonomy Code: 208200000X

State License MN 64276

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

Secondary Practice Locations

525 Oak Centre Dr Ste 260

San Antonio, TX 782583945

Phone: 6037316888

12505 Quaker Ave Ste A

Lubbock, TX 794247743

Phone: 6037316888

Practice Associates & Co-Workers

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

40 Associated Practitioners
Mitchell Johnson

Student in an Organized Health Care Education/Training Program

NPI 1003603465
Jenise Glass , FNP

Nurse Practitioner - Family

NPI 1003647017

Family Nurse Practitioner

Dr. Andrew Mckeen , MD

Student in an Organized Health Care Education/Training Program

NPI 1023802048

Doctor of Medicine (M.D.)

Dr. Chi Vu , MD

Family Medicine

NPI 1033171525

Doctor of Medicine (M.D.)

Dr. David Grissom , MD

Internal Medicine

NPI 1033188677

Doctor of Medicine (M.D.)

Marian James , FNP-C

Nurse Practitioner - Family

NPI 1033687256

Family Nurse Practitioner (Certified)

Career & Practice History Timeline

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

22 Historical Events
📍
Updated Practice Location December 20, 2024

Registered at 1500 S MAIN ST, FORT WORTH, TX 761044917 (Tel: 8177021100)

📍
Updated Business Mailing Address December 20, 2024

Registered at PO BOX 732973, DALLAS, TX 753732973

📍
Updated Practice Location August 16, 2024

Registered at 525 OAK CENTRE DR STE 260, SAN ANTONIO, TX 782583945 (Tel: 6037316888)

📍
Updated Business Mailing Address August 16, 2024

Registered at 115 N VICKSBURG AVE, LUBBOCK, TX 794163020 (Tel: 6037316888)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 16, 2024

Plastic Surgery (License #28451 in MN)

📍
Updated Practice Location April 18, 2024

Registered at 3813 22ND ST STE E, LUBBOCK, TX 794101156 (Tel: 6037316888)

📍
Updated Business Mailing Address April 18, 2024

Registered at 3813 22ND ST STE E, LUBBOCK, TX 794101156 (Tel: 6037316888)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 18, 2024

Plastic Surgery (License #64276 in MN)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 08, 2024

Plastic Surgery (License #28451 in MN)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 24, 2020

Plastic Surgery (License #64276 in MN)

📍
Updated Practice Location July 23, 2018

Registered at 200 1ST ST SW, ROCHESTER, MN 55905 (Tel: 5072842511)

NPI Profile Active November 06, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location November 06, 2017

Registered at 200 1ST ST SW, ROCHESTER, MN 559050001 (Tel: 5072842511)

📍
Updated Business Mailing Address November 06, 2017

Registered at 200 1ST ST SW, ROCHESTER, MN 559050001 (Tel: 5072842511)

👤
Provider Name / Credentials Updated November 06, 2017

Recorded as THANAPOOM BOONIPAT

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 06, 2017

Plastic Surgery (License #28451 in MN)

NPI Profile Active March 24, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location March 24, 2017

Registered at 200 1ST ST SW, ROCHESTER, MN 559050001 (Tel: 5072842511)

📍
Updated Business Mailing Address March 24, 2017

Registered at 200 1ST ST SW, ROCHESTER, MN 559050001 (Tel: 5072842511)

👤
Provider Name / Credentials Updated March 24, 2017

Recorded as THANAPOOM BOONIPAT

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 24, 2017

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration March 24, 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: 1154852705
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 24, 2017
Last Update: December 20, 2024
Sole Proprietor: No

Mailing Address

Po Box 732973

Dallas, TX 753732973

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.