Individual provider Active NPI

Samuel Thomas Klinker

  • Surgery Physician
  • La Crosse, WI
National Provider Identifier
1023571148
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
74369 Issued in WI
Practice address
1836 South Ave
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
Apr 8, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 74369 WI Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240909001621 WI Practitioner - General Surgery 1153656368 Reassigns benefits to 1 organization
I20250716003698 MN Practitioner - General Surgery 1153656368 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare Clinic Southwest LLCGroup PAC ID 8426457946, 172 clinicians

Practice addresses (Care Compare)

101 Willmar Ave SW
Willmar, MN 56201-3556
Phone (320) 231-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy20
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux34
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
74369WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Southwest LLC CurrentSince Jul 1, 2025 Accepting new patients
Centracare Clinic Southwest LLC CurrentSince Jul 1, 2025 Accepting new patients
Carris Health - Redwood LLC CurrentSince Jul 1, 2025 Accepting new patients
Carris Health - Redwood LLC Current Accepting new patients
Redwood Area Hospital Current Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Aug 26, 2024 Accepting new patients
Carris Health - Redwood LLC CurrentSince Jul 1, 2025 Accepting new patients
Centracare Health - Benson LLC Current Accepting new patients
Centracare Health - Benson LLC CurrentSince Jul 1, 2025 Accepting new patients
Centracare Health - Benson LLC CurrentSince Jul 1, 2025 Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Swift County Benson Hospital Current Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Aug 26, 2024 Accepting new patients

Locations

1815 Wisconsin Ave
Benson, MN 56215
Phone (320) 843-3454

600 Peterson Pkwy
New London, MN 56273
Phone (320) 354-2222

101 Caring Way
Redwood Falls, MN 56283
Phone (507) 637-2911

101 Willmar Ave SW
Willmar, MN 56201
Phone (320) 231-5079

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

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

Interoperability endpoints

  • Direct secure messaging: sklinker315927@direct.emplifyhealth.org
  • Direct secure messaging: sklinker887082@direct.centracare.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 3

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1023571148",
    "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": "KLINKER",
        "first_name": "SAMUEL",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-08",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "74369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.