MR. THOTSAPHONE KHAMPANE P.A.C.
NPI 1164585691
Physician Assistant in Milwaukee, WI

Q: What is Thotsaphone Khampane's NPI number?

The NPI number for Thotsaphone Khampane is 1164585691. It was assigned to this individual provider in the NPPES registry on December 18, 2006.

Q: What is Thotsaphone Khampane's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Active since December 18, 2006PECOS EnrolledAccepts Medicare Assignment

945 N 12TH ST, MILWAUKEE, WI 53233(414) 219-6777 Get Directions Write a Review

NPPES record last updated: December 6, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 6, 2024, Dec 28, 2021, Apr 23, 2018 (3 updates tracked since 2018).

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About Mr. Thotsaphone Khampane P.a.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. THOTSAPHONE KHAMPANE P.A.C. (NPI 1164585691) is an individual physician assistant in Milwaukee, Wisconsin, licensed in Wisconsin (822-023) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS, is affiliated with Aurora St Lukes Medical Center, and is a graduate of Other (1993).

NPPES Registry Identity

NPI1164585691

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMR. THOTSAPHONE KHAMPANECredential: P.A.C.

Location Address945 N 12TH STMilwaukee, WI 53233-1305

Mailing AddressPo Box 735044Chicago, IL 60673-5044 · (800) 326-2250

Phone(414) 219-6777

Sole ProprietorNo

Medical School CMSOtherGraduated 1993

Enumeration DateDecember 18, 2006

Last NPPES UpdateDecember 6, 20243 updates tracked since enumeration

NPPES CertifiedDecember 6, 2024

✔ NPI 1164585691 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in WI · 822-023

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

945 N 12TH ST, Milwaukee, WI 53233

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Other Identifiers 1

Medicaid42966900WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource (Common Ground Healthcare), UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Thotsaphone Khampane P.a.c. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6406856913

PECOS Enrollment IDI20070108000178

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

28 services26 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Aurora St Lukes Medical Center

Acute Care Hospitals · Milwaukee, WI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520138

Location2900 W Oklahoma AveMilwaukee, WI 53215 · Milwaukee County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53233 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RANA MOHAMMED AL RUBAYE MD

Student in an Organized Health Care Education/Training Program