Individual provider Active NPI

Bradley Duane Maurhoff, PA-C

  • Medical Physician Assistant
  • Tomah, WI
National Provider Identifier
1053561852
Registry record updated May 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2338-23 Issued in WI
Practice address
1330 N Superior Ave
Tomah, WI 54660-1130
Phone
(608) 372-4111
NPI assigned
Sep 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2338-23 WI Primary

Addresses

Primary practice location

1330 N Superior Ave
Tomah, WI 54660-1130

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
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120606000359 WI Practitioner - Physician Assistant 1850555723 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gundersen Clinic LTDGroup PAC ID 9638082779, 422 clinicians

Practice addresses (Care Compare)

1111 W Wisconsin St
Sparta, WI 54656-2233
Phone (608) 269-6731

402 A W Lake St
Friendship, WI 53934-9699
Phone (608) 339-8471

402 W Lake St
Friendship, WI 53934-9699
Phone (608) 339-3331

505 Gopher Dr
Tomah, WI 54660-4513
Phone (608) 372-4111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2338WIMDGeneral Practice Dentistry
2338-23WIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Clinic LTD CurrentSince May 7, 2012 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc. CurrentSince May 1, 2018 Accepting new patients
Gundersen Lutheran Express Care, Inc CurrentSince May 7, 2012 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc Past Accepting new patients
Gundersen Clinic LTD Past Accepting new patients
Gundersen Clinic, LTD. Past Accepting new patients

Locations

402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331

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

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

1600 Main St
Onalaska, WI 54650
Phone (608) 783-4681

1111 W Wisconsin St
Sparta, WI 54656
Phone (608) 263-9531

1330 N Superior Ave
Tomah, WI 54660
Phone (608) 372-4111

505 Gopher Dr
Tomah, WI 54660
Phone (608) 372-2181

Interoperability endpoints

  • Direct secure messaging: bmaurhoff57473@direct.emplifyhealth.org

Organizations & group practices 6

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 8

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": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335916800000",
    "number": "1053561852",
    "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": "1330 N SUPERIOR AVE",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546601130",
            "telephone_number": "608-372-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURHOFF",
        "first_name": "BRADLEY",
        "middle_name": "DUANE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-29",
        "last_updated": "2012-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "2338-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomah, WI

Sources for this page

Verify at the official NPI Registry.