NPIMap

Samuel D Brauer, PA

Individual provider Active NPI Physician Assistant · La Crosse, WI

NPI 1013380138 · NPPES record last updated Mar 24, 2022

Key facts

NPI
1013380138
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
5381-23 (WI)
Practice address
2222 Kwik Trip Way
La Crosse, WI 54603-3238
Phone
(608) 781-5848
Fax
(608) 781-5587
NPI assigned
Nov 11, 2015
Sex
Male
Sole proprietor
No

Organizations & group practices 15

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Health Services of Howard County (27 clinicians)

Practice addresses (Care Compare)

321 8TH Ave W
Cresco, IA 52136-1064
Phone (563) 547-2021

Hospital & facility affiliations

  • Regional Health Services of Howard County Hospital · Cresco, IA · CCN 161328

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in IA, WI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20151229000140 IA Practitioner - Physician Assistant 1557662087 Reassigns benefits to 3 organizations
I20220929003731 WI Practitioner - Physician Assistant 1557662087 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
12647MNMDPhysician Assistant
5381-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Clinic LTD Current
since Nov 21, 2015		 Accepting new patients
Premise Health of Wisconsin Medical, S.C. Current
since Jun 18, 2023		 Accepting new patients
Regional Health Services of Howard County Current
since Jun 14, 2023		 Accepting new patients
Palmer Lutheran Health Center, Inc. Current
since Dec 28, 2016		 Accepting new patients
Regional Health Services of Howard County Current
since Jun 14, 2023		 Accepting new patients
Gundersen Lutheran Express Care, Inc Current
since Nov 21, 2015		 Accepting new patients
Regional Health Services of Howard County Past Accepting new patients

Locations

235 8th Ave W
Cresco, IA 52136
Phone (319) 547-2101

321 8th Ave W
Cresco, IA 52136
Phone (563) 547-2021

110 Jefferson St
West Union, IA 52175
Phone (319) 422-3817

112 Jefferson St
West Union, IA 52175
Phone (563) 422-3811

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

2222 Kwik Trip Way
La Crosse, WI 54603
Phone (608) 780-2269

Interoperability endpoints

  • Direct secure messaging: samuel.brauer@avera.sdhealthlink.net
  • Direct secure messaging: sbrauer135868@direct.gundersenhealth.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 079619 IA
Physician Assistant 363A00000X 12647 MN
Physician Assistant 363A00000X 5381-23 WI Yes

Addresses

Primary practice location

2222 Kwik Trip Way
La Crosse, WI 54603-3238

Mailing address

606 Washington St
Decorah, IA 52101-2266
Phone (507) 206-9472

Other providers in La Crosse, WI

All providers in La Crosse, WI · Physician Assistant in Wisconsin

Sources for this page

Verify at the official NPI Registry.