Individual provider Active NPI

Andrew M Thorson, MD

  • Emergency Medicine Physician
  • Sheboygan, WI
National Provider Identifier
1376930214
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
74204 Issued in WI
Practice address
3400 Union Ave
Sheboygan, WI 53081-8426
Phone
(920) 802-2100
NPI assigned
Apr 17, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 74204 WI Primary
Emergency Medicine Physician 207P00000X 51274 KY

Addresses

Primary practice location

3400 Union Ave
Sheboygan, WI 53081-8426

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (920) 802-2100

Other practice location 1

2629 N 7th St
Sheboygan, WI 53083-4932
Phone (920) 451-5000

Other practice location 2

4802 10th Avenue
Maimonides Medical Center
Brooklyn, NY 11219
Phone (718) 283-6879

Other identifiers 1

IdentifierTypeStateIssuer
100109122MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address athorson281422@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201029002175 WI Practitioner - Emergency Medicine 6204191869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

2629 N 7TH St
Sheboygan, WI 53083-4932
Phone (920) 451-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51274KYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Oct 26, 2020 Accepting new patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 26, 2020 Accepting new patients
North Carolina Em I Medical Services P C Past Accepting new patients
Ky-I Medical Services, P.S.C. Past Accepting new patients

Locations

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

3400 Union Ave
Sheboygan, WI 53081
Phone (920) 802-2100

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1429228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1376930214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "920-802-2100",
            "fax_number": "920-802-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 UNION AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530818426",
            "telephone_number": "920-802-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2629 N 7th St",
            "address_purpose": "LOCATION",
            "city": "Sheboygan",
            "state": "WI",
            "postal_code": "530834932",
            "country_code": "US",
            "telephone_number": "920-451-5000",
            "fax_number": "920-451-5333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4802 10th Avenue",
            "address_2": "Maimonides Medical Center",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11219",
            "country_code": "US",
            "telephone_number": "718-283-6879",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THORSON",
        "first_name": "ANDREW",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-17",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "74204",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "51274",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100109122",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "athorson281422@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2629 N 7th St",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530834932",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2629 N 7th St",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530834932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

Verify at the official NPI Registry.