Individual provider Active NPI

Somchai Laowattana, MD

  • Neurology Physician
  • Milwaukee, WI
National Provider Identifier
1245315365
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
52265-20 Issued in WI
Practice address
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone
(414) 805-5200
Fax
(414) 259-0469
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 036154960 IL
Neurology Physician 2084N0400X 52265-20 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522

Mailing address

12632 S Harlem Ave
Palos Heights, IL 60463-1428
Phone (708) 587-0000

Other practice location 1

1700 W Paradise Dr
West Bend, WI 53095-9795
Phone (262) 334-3451

Other practice location 2

3700 W 203rd St Ste 201
Olympia Fields, IL 60461-1182
Phone (708) 679-2120

Other identifiers 1

IdentifierTypeStateIssuer
1245315365MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
40762TXMDClinical Psychologist
036154960ILMDNeurology Physician
52265-20WIMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Almasri and Associates Inc. CurrentSince Jun 6, 2021 Accepting new patients
United Elite Hospitalists, LLC CurrentSince Jun 6, 2021 Accepting new patients

Locations

12632 S Harlem Ave
Palos Heights, IL 60463
Phone (708) 587-0000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1245315365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12632 S HARLEM AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631428",
            "telephone_number": "708-587-0000",
            "fax_number": "708-623-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-5200",
            "fax_number": "414-259-0469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 W Paradise Dr",
            "address_purpose": "LOCATION",
            "city": "West Bend",
            "state": "WI",
            "postal_code": "530959795",
            "country_code": "US",
            "telephone_number": "262-334-3451",
            "fax_number": "262-334-5321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3700 W 203rd St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Olympia Fields",
            "state": "IL",
            "postal_code": "604611182",
            "country_code": "US",
            "telephone_number": "708-679-2120",
            "fax_number": "708-503-3230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAOWATTANA",
        "first_name": "SOMCHAI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036154960",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "52265-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245315365",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.