Active NPI
Lane Clayton Thaut, D.O.
- Emergency Medicine Physician
- Park City, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- DOS-1915
- Practice address
- 1743 S Sidewinder Drive Unit 114
Park City, UT 84060 - Phone
- (307) 840-9834
- NPI assigned
- Mar 18, 2016
- Last updated
- Dec 3, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 17163 | CA | |
| Obesity Medicine (Preventive Medicine) Physician | 2083B0002X | DOS-1915 | HI | |
| Emergency Medicine Physician | 207P00000X | DOS-1915 | HI | Primary |
| Emergency Medicine Physician | 207P00000X | R4911 | TX |
Addresses
Primary practice location
1743 S Sidewinder Drive Unit 114
Park City, UT 84060
Mailing address
1743 Sidewinder Dr Unit 114
Park City, UT 84060-7322
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, HI, WI, CO, UT, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 6
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Rocky Vista University College of Osteopathic Med, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
270 Dairy Rd
Suite 239
Kahului, HI 96732-2986
Phone (808) 667-6161
800 E Blackhawk Ave
Prairie Du Chien, WI 53821-1698
Phone (608) 326-0808
800 W Ave S
La Crosse, WI 54601-8806
Phone (608) 785-0940
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R4911 | TX | MD | Emergency Medicine Physician |
| DOS-1915 | HI | MD | Obesity Medicine (Preventive Medicine) Physician |
| 17163 | CA | MD | Physical Rehabilitation Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayo Clinic Health System-Southwest Wisconsin Region, Inc. | Current | Accepting new patients | |
| Woodland Emergency Physicians Medical Group Inc | Emergency Medicine | Current | Accepting new patients |
| RP Medical LLC | General Practice | Current | Accepting new patients |
| True North Medical of Stony Brook, P.C. | Family Medicine | Current | Accepting new patients |
| Emerald Medical Practice PC | Current | Accepting new patients | |
| Hawaii Emergency Physicians Associated Inc | Emergency Medicine | Current | Accepting new patients |
| Mayo Clinic Health System-Southwest Wisconsin Region, Inc. | Current | Accepting new patients | |
| Cloud Health Medical Group of California, P.C. | Family Medicine | Past | Accepting new patients |
Locations
710 Lakeway Dr
Ste 200
Sunnyvale, CA 94085
Phone (408) 372-6205
1325 Cottonwood St
Woodland, CA 95695
Phone (530) 662-3961
4770 Baseline Rd
Ste 200
Boulder, CO 80303
Phone (307) 840-9834
1201 Hays St
Tallahassee, FL 32301
Phone (855) 522-7233
289 S Culver St
Lawrenceville, GA 30046
Phone (404) 458-0809
270 Dairy Rd
Ste 239
Kahului, HI 96732
640 Ulukahiki St
Kailua, HI 96734
Phone (808) 261-3326
79-1019 Haukapila St
Kealakekua, HI 96750
Phone (808) 322-4413
128 Lehua St
Wahiawa, HI 96786
Phone (808) 621-4330
801 Adlai Stevenson Dr
Springfield, IL 62703
Phone 4153603833 ext. 03833
475 Hillside Ave
Ste 4
Needham Hgts, MA 02494
3410 Belle Chase Way
Ste 600
Lansing, MI 48911
Phone (517) 999-9020
200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850
100 Charles Ewing Blvd
Ste 160
Trenton, NJ 08628
Phone (833) 484-6359
2119 Merrick Rd
Merrick, NY 11566
Phone (516) 377-2820
1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650
10 W 37th St
Fl 5
New York, NY 10018
Phone (929) 296-1624
1160 Dublin Rd
Ste 400
Columbus, OH 43215
Phone (502) 439-2617
211 E 7th St
Ste 620
Austin, TX 78701
Phone (415) 742-8411
1743 Sidewinder Dr
Unit 114
Park City, UT 84060
Phone (307) 840-9834
800 E Blackhawk Ave
Prairie du Chien, WI 53821
Phone (608) 326-0808
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
Interoperability endpoints
- lthaut375924@northwell.direct-ci.com
- lane.thaut.2@30093.direct.athenahealth.com
Organizations & group practices 8
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Mayo Clinic Health System - La Crosse
- Multi-Specialty Clinic/Center
- La Crosse, WI
- NPI 1629056049
-
dba Minit Medical Urgent Care Center
- Urgent Care Clinic/Center
- Kahului, HI
- NPI 1982094652
General Practice
-
dba HEPA, Inc.
- Emergency Medicine Physician
- Kailua, HI
- NPI 1801843198
-
- Internal Medicine Physician
- Merrick, NY
- NPI 1649098203
Family Medicine
-
- Emergency Medicine Physician
- Woodland, CA
- NPI 1881868164
-
dba Mayo Clinic Health System - La Crosse
- Multi-Specialty Clinic/Center
- La Crosse, WI
- NPI 1942980917
-
- Internal Medicine Physician
- San Francisco, CA
- NPI 1194404327
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764720000000",
"number": "1174984058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1743 SIDEWINDER DR UNIT 114",
"city": "PARK CITY",
"state": "UT",
"postal_code": "840607322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1743 S SIDEWINDER DRIVE UNIT 114",
"city": "PARK CITY",
"state": "UT",
"postal_code": "84060",
"telephone_number": "307-840-9834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAUT",
"first_name": "LANE",
"middle_name": "CLAYTON",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-18",
"last_updated": "2025-12-03",
"certification_date": "2025-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "17163",
"primary": false
},
{
"code": "2083B0002X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Obesity Medicine",
"state": "HI",
"license": "DOS-1915",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "HI",
"license": "DOS-1915",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "TX",
"license": "R4911",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Park City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.