Smathorn Thakolwiboon, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

81956 Issued in WI

Practice address

800 West Ave S
La Crosse, WI 54601-8806

Phone

(608) 785-0940

NPI assigned

Jun 26, 2017

Last updated

Aug 23, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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

Neurology

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mayo Clinic Health System-Southwest Wisconsin Region IncGroup PAC ID 0345152443, 539 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mayo Clinic Health System-Franciscan Medical Center Inc Hospital, La Crosse, WI, CCN 520004
• Mayo Clinic HLTH Systm Franciscan Hlthcare Sparta Hospital, Sparta, WI, CCN 521305
• Mayo Clinic Health System Eau Claire Hospital Hospital, Eau Claire, WI, CCN 520070
• Tomah Memorial Hospital Hospital, Tomah, WI, CCN 521320
• Veterans Memorial Hospital Hospital, Waukon, IA, CCN 161318

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sthakolwiboon1745183@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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

  dba Mayo Clinic Health System - La Crosse

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

  dba Mayo Clinic Health System - La Crosse

  • Multi-Specialty Clinic/Center
  • La Crosse, WI
  • NPI 1942980917
  NPD
• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  dba Franciscan Healthcare - La Crosse

  • General Acute Care Hospital
  • La Crosse, WI
  • NPI 1801874227
  NPD (past)

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

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

  dba Mayo Clinic Health System in Eau Claire

  • General Acute Care Hospital
  • Eau Claire, WI
  • NPI 1629027578
  Care Compare affiliation
• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  dba Franciscan Healthcare - La Crosse

  • General Acute Care Hospital
  • La Crosse, WI
  • NPI 1801874227
  Care Compare affiliation
• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  dba Franciscan Healthcare - Sparta

  • Critical Access Hospital
  • Sparta, WI
  • NPI 1841278637
  Care Compare affiliation
• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  dba Mayo Clinic Health System - Arcadia

  • Rural Health Clinic/Center
  • Arcadia, WI
  • NPI 1972091361

  Hospital

  Care Compare affiliation
• Tomah Memorial Hospital Inc

  dba Tomah Health

  • Critical Access Hospital
  • Tomah, WI
  • NPI 1184765240
  Care Compare affiliation
• Veterans Memorial Hospital City of Waukon Ia

  • Critical Access Hospital
  • Waukon, IA
  • NPI 1164599643
  Care Compare affiliation

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1619497161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WEST AVE S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546018806",
            "telephone_number": "608-785-0940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559058321",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3601 4th St Stop 8321",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794308321",
            "country_code": "US",
            "telephone_number": "806-743-2391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THAKOLWIBOON",
        "first_name": "SMATHORN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-26",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "71046",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "BP10059611",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "81956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sthakolwiboon1745183@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559058321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.