Theodore William Vanderhorst, D.O.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

62064 Issued in WI

Practice address

700 West Ave S
La Crosse, WI 54601-4783

Phone

(608) 785-0940

Fax

(608) 392-7197

NPI assigned

Jun 1, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mayo Clinic Health System-Southwest Wisconsin Region IncGroup PAC ID 0345152443, shared by 9 NPIs, 539 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mayo Clinic Health System-Franciscan Medical Center Inc Hospital, La Crosse, WI, CCN 520004

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tvanderhorst28364@ehrdirect.mayoclinicmsg.org

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.

• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  • Multi-Specialty Clinic/Center
  • La Crosse, WI
  • NPI 1629056049
  Medicare reassignment NPD
• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  • Critical Access Hospital
  • Sparta, WI
  • NPI 1841278637
  Medicare reassignment NPD
• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  • Multi-Specialty Clinic/Center
  • La Crosse, WI
  • NPI 1942980917
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  • General Acute Care Hospital
  • La Crosse, WI
  • NPI 1801874227
  Care Compare affiliation

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

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1336468362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 WEST AVE S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014783",
            "telephone_number": "608-785-0940",
            "fax_number": "608-392-7197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 WEST AVE S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014783",
            "telephone_number": "608-785-0940",
            "fax_number": "608-392-7197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERHORST",
        "first_name": "THEODORE",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-01",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IA",
            "license": "R - 8887",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "62064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tvanderhorst28364@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "700 West Ave S",
            "city": "LA Crosse",
            "state": "WI",
            "country_code": "US",
            "postal_code": "546014783",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrea J Van Wyk, M.D.
• Sylvia V Vanatta, M.D.
• Torey J Vande Walle, DDS
• Joseph P Vandenberg, MD
• Samantha J Vander Bloomen, RD
• Laura K Vanderlei, PA
• Barbara J Vandreese, APNP
• Anthony Vang
• Shoua Vang, BACHELOR OF SCIENCE
• Charlene Ingrid Vangen, BSW

• Anesthesiology Physician in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Anesthesiology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.

Verify at the official NPI Registry.