Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Thotsaphone Khampane, PAC

Individual provider Physician Assistant · NPI 1164585691

Mr. Thotsaphone Khampane, PAC is a Physician Assistant in Milwaukee, Wisconsin. Qualified in 1993, 33 years ago. Practices with Aurora Medical Group, Inc, a 3,741-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
33
Licensed in
WI
In the registry since
2006
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

945 N 12th St
Milwaukee, WI 53233-1305
Phone: (414) 219-6777
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 822-023 (WI)

Record details

NPI number1164585691
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedDecember 18, 2006
Last updated in NPPESDecember 6, 2024
Certification dateDecember 6, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1993 (33 years in practice)
Group practice Aurora Medical Group, Inc. — 3741 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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