Active NPI
Piraon Sutthiwan, M.D.
- Cardiovascular Disease Physician
- La Crosse, WI
National Provider Identifier
1740252345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 53926
- Practice address
- 1836 South Ave
La Crosse, WI 54601-5429 - Phone
- (608) 782-7300
- NPI assigned
- Feb 7, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | L8970 | TX | |
| Cardiovascular Disease Physician | 207RC0000X | L8970 | TX | |
| Cardiovascular Disease Physician | 207RC0000X | 53926 | WI | Primary |
| Cardiovascular Disease Physician | 207RC0000X | 38974 | IA | |
| Cardiovascular Disease Physician | 207RC0000X | 53203 | MN |
Addresses
Primary practice location
1836 South Ave
La Crosse, WI 54601-5429
Mailing address
1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 144017101 | Medicaid | TX | |
| 450686CI134021 | Other | TX | SECTION 1011 |
| 202000019 | Medicaid | NM | |
| 87915Z | Other | TX | HMO BLUE |
| 174287602 | Medicaid | TX | |
| 200056480A | Medicaid | OK | |
| 174287601 | Medicaid | TX | |
| 8S5200 | Other | TX | BC/BS |
| 144017100 | Other | TX | FIRSTCARE COMMERCIAL |
| 202000019 | Other | NM | PRESBYTERIAN COMMERCIAL |
| 56185278 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38974 | IA | MD | Cardiovascular Disease Physician |
| L8970 | TX | MD | Cardiovascular Disease Physician |
| 53926 | WI | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Tech University Health Sciences Center - Son - Lubbock | Past | Accepting new patients |
Interoperability endpoints
- psutthiwan16513@direct.gundersenhealth.org
Organizations & group practices 1
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.
-
- Federally Qualified Health Center (FQHC)
- Abilene, TX
- NPI 1265810642
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433376000000",
"number": "1740252345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1836 SOUTH AVE",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546015429",
"telephone_number": "608-782-7300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1836 SOUTH AVE",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546015429",
"telephone_number": "608-782-7300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTTHIWAN",
"first_name": "PIRAON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-07",
"last_updated": "2015-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "L8970",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "TX",
"license": "L8970",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "WI",
"license": "53926",
"primary": true
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "IA",
"license": "38974",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "MN",
"license": "53203",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "144017101",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SECTION 1011",
"identifier": "450686CI134021",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "202000019",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMO BLUE",
"identifier": "87915Z",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "174287602",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200056480A",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "174287601",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "8S5200",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRSTCARE COMMERCIAL",
"identifier": "144017100",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRESBYTERIAN COMMERCIAL",
"identifier": "202000019",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "56185278",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in La Crosse, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.