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

Sourasack Kit Vongsa, MD

Individual provider Family Medicine Physician · NPI 1619945524

Sourasack Kit Vongsa, MD is a Family Practice in Appleton, Wisconsin. Qualified in 2003, 23 years ago. Practices with Thedacare, Incorporated, a 654-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
23
Licensed in
WI
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2500 E Capitol Dr Ste 1200
Appleton, WI 54911
Phone: (920) 830-6877
Fax: (800) 236-2236
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 3329 N Richmond St, Appleton, WI 54911 — (920) 380-2727
  • 3329 N Richmond St, Appleton, WI 54911 — (920) 380-2727
  • 3329 N Richmond St, Appleton, WI 54911 — (920) 380-2727
  • 3329 N Richmond St, Appleton, WI 54911 — (920) 380-2727

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 47253 (WI)

Record details

NPI number1619945524
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 8, 2006
Last updated in NPPESAugust 19, 2019

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Thedacare, Incorporated — 654 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

Other providers in Appleton