NPIMap

Individual provider Active NPI

Thao Lo, PA-C

  • Physician Assistant
  • Wausau, WI
National Provider Identifier
1598005050
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3076-23 Issued in WI
Practice address
2727 Plaza Dr
Wausau, WI 54401
Phone
(715) 847-3000
NPI assigned
Feb 20, 2013
Last updated
May 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3076-23 WI Primary

Addresses

Primary practice location

2727 Plaza Dr
Wausau, WI 54401

Mailing address

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

Other practice location 1

1117 S 12th Ave
Wausau, WI 54401-5802
Phone (651) 231-7363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130403000595 WI Practitioner - Physician Assistant 3173768611 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Connection Health Care, Inc.Group PAC ID 3870577935, 9 clinicians

Practice addresses (Care Compare)

1810 N 2ND St
Wausau, WI 54403-3492
Phone (715) 848-4884

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3076-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MCHS Hospitals Inc Current Accepting new patients
Marshfield Clinic Inc CurrentSince May 15, 2017 Accepting new patients

Locations

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

2727 Plaza Dr
Wausau, WI 54401
Phone (715) 847-3000

Interoperability endpoints

  • Direct secure messaging: thao.lo@337248305217540.direct.elationemr.com
  • Direct secure messaging: thao.lo@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 3

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.

Hospital & facility affiliations 11

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": "1361318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1598005050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-387-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 PLAZA DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "54401",
            "telephone_number": "715-847-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1117 S 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Wausau",
            "state": "WI",
            "postal_code": "544015802",
            "country_code": "US",
            "telephone_number": "651-231-7363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LO",
        "first_name": "THAO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-20",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3076-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.