Panithaya Chareonthaitawee, M.D.
Individual provider Active NPI Cardiovascular Disease Physician · Rochester, MN
NPI 1730165770 · NPPES record last updated Aug 12, 2020
Key facts
- NPI
- 1730165770
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 36241 (MN)
- Practice address
- 200 1St St SW
Rochester, MN 55905-0001 - Phone
- (507) 284-2511
- NPI assigned
- Dec 21, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 29
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Northwestern University Feinberg Medical School, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mayo Clinic Health System-Southwest Minnesota Region
Mayo Clinic Health System-Fairmont
Mayo Clinic
Mayo Clinic Health System-Southeast Minnesota Region
Practice addresses (Care Compare)
1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031
200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511
200 1St SWST
Rochester, MN 55905-0001
2200 NW 26TH St
Owatonna, MN 55060-5503
Phone (507) 451-1120
2250 NW 26TH St
Owatonna, MN 55060-5503
Phone (507) 451-3850
404 W Fountain St
Albert Lea, MN 56007-2437
Phone (507) 373-2384
800 Medical Ctr Dr
Fairmont, MN 56031-4575
Phone (507) 238-8555
Hospital & facility affiliations
- Mayo Clinic Hospital Rochester
- Mayo Clinic Health System - Mankato
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN, IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100125000504 | MN | Practitioner - Cardiovascular Disease (Cardiology) | 6103968474 | Reassigns benefits to 6 organizations |
| I20180824001799 | IA | Practitioner - Cardiovascular Disease (Cardiology) | 6103968474 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayo Clinic Health System-Southwest Minnesota Region | Current |
Accepting new patients | |
| Mayo Clinic Health System-Southwest Minnesota Region | Current | Accepting new patients | |
| Mayo Clinic Health System-Southeast Minnesota Region | Current |
Accepting new patients | |
| Mayo Clinic Health System-Southwest Minnesota Region | Current |
Accepting new patients | |
| Mayo Clinic | Current |
Accepting new patients | |
| Winneshiek Medical Center | Current |
Accepting new patients | |
| Winneshiek Medical Center | Current |
Accepting new patients | |
| Winneshiek Medical Center | Current |
Accepting new patients | |
| Mayo Clinic | Current |
Accepting new patients | |
| Winneshiek Medical Center | Current | Accepting new patients | |
| Mayo Clinic Health System-Fairmont | Current |
Accepting new patients | |
| Mayo Clinic Health System-Southeast Minnesota Region | Current |
Accepting new patients | |
| Mayo Clinic | Past | Accepting new patients | |
| Mayo Clinic Hospital-Rochester | Past | Accepting new patients |
Locations
901 Montgomery St
Decorah, IA 52101
Phone (319) 382-2911
112 Jefferson St
West Union, IA 52175
Phone (563) 422-3811
404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285
800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100
114 Main St S
Mabel, MN 55954
Phone (507) 493-5115
1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623
200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850
Interoperability endpoints
- pchareonthaitawee132311@ehrdirect.mayoclinicmsg.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 36241 | MN | Yes |
Addresses
Primary practice location
200 1St St SW
Rochester, MN 55905-0001
Mailing address
200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 887723800 | Medicaid | MN |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pchareonthaitawee132311@ehrdirect.mayoclinicmsg.org |
Other providers in Rochester, MN
- Richard W Chapman
- Ammar Farook Chapra
- Ali Hani Charafeddine
- J W Charboneau
- Katy L Charboneau
- Sara Charki
- Jennifer Charlebois
- Jonathan Elliot Charnin
- Charterhouse Inc
- Stephane Rene Chartier
All providers in Rochester, MN · Cardiovascular Disease Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.