SOUKTHANOME THAMMAVONG LICSW
NPI 1164986246
Social Worker - Clinical in Columbia Heights, MN
About Soukthanome Thammavong Licsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUKTHANOME THAMMAVONG LICSW (NPI 1164986246) is an individual clinical provider in Columbia Heights, Minnesota and active in the NPI registry since January 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Minneapolis, and is a graduate of Other (2008).
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Soukthanome Thammavong Licsw 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.
Medicare Billing Reassignment
Medicare enrollment records show Soukthanome Thammavong reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Minneapolis, MN 55413
- Reassigned Medicare billing, Minnesota enrollment
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55421 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Soukthanome Thammavong's NPI number?
The NPI number for Soukthanome Thammavong is 1164986246. It was assigned to this individual provider in the NPPES registry on January 23, 2019. The provider is also known as Nome Thammavong Licsw.
Where is Soukthanome Thammavong located?
Soukthanome Thammavong practices at 4111 Central Ave NE Ste 201, Columbia Heights, MN 55421. The listed phone number is (763) 283-7194.
What is Soukthanome Thammavong's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Soukthanome Thammavong enrolled in Medicare?
Yes. Soukthanome Thammavong is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Soukthanome Thammavong's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Soukthanome Thammavong reassigns Medicare benefits to Anoka Health Center LLC (Minneapolis, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Soukthanome Thammavong's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Soukthanome Thammavong accept?
Health plans from Medica list Soukthanome Thammavong as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Soukthanome Thammavong was last updated on April 25, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Soukthanome Thammavong, LICSW · NPI 1164986246
Clinical provider in Columbia Heights, Minnesota. Individual provider, active in the CMS NPPES registry since January 23, 2019.
## Identity
- **NPI:** 1164986246 (Entity type: Individual)
- **Enumerated:** January 23, 2019
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **Sole proprietor:** No
## Practice location
- **Address:** 4111 CENTRAL AVE NE STE 201, Columbia Heights, MN 55421-2960
- **Phone:** (763) 283-7194 · **Fax:** (612) 437-4535
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Anoka Health Center LLC (NPI 1053816389, Minneapolis, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2008
## Record status
- **NPPES last updated:** April 25, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1164986246) · Data from the CMS NPPES public registry.