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

Promporn June Suwanabol

Individual provider Medical Physician Assistant · NPI 1710395058

Promporn June Suwanabol is a Physician Assistant in Watertown, Wisconsin. Qualified in 2014, 12 years ago. Practices with Watertown Physician Practices LLC, a 63-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.

Years since qualifying
12
Licensed in
WI
In the registry since
2014
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Practice location Address checks out

123 Hospital Dr Ste 2009
Watertown, WI 53098-3331 Not confirmed with CMS for 11 years — call before visiting
Phone: (920) 262-9833
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 3398-23 (WI)

Record details

NPI number1710395058
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 30, 2014
Last updated in NPPESDecember 16, 2014

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Watertown Physician Practices Llc — 63 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients207
Services billed 863 a service is one billed item, such as a visit, a test or a procedure
Average patient age73

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician. Those with a page here are linked.

Colleagues at Watertown Physician Practices LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 63 clinicians in the practice; 12 are shown here.

Other providers in Watertown