Individual provider Active NPI

Jeffrey Karl Buikema, PHD, LPC

  • Professional Counselor
  • La Crosse, WI
National Provider Identifier
1073659801
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4262 Issued in WI
Practice address
201 Main St Ste 500
La Crosse, WI 54601-0716
Phone
(608) 668-4005
Fax
(608) 668-4006
NPI assigned
Jan 29, 2007
Last updated
Nov 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4262 WI Primary
Marriage & Family Therapist 106H00000X 229-124 WI

Addresses

Primary practice location

201 Main St Ste 500
La Crosse, WI 54601-0716

Mailing address

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789
Phone (651) 628-9566

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241119002170 WI Practitioner - Mental Health Counselor 7911432687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

201 Main St
Suite 500
La Crosse, WI 54601-0716
Phone (608) 668-4005

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4262WIMDProfessional Counselor
229-124WIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates Counseling Wi., S.C. CurrentSince Nov 11, 2024 Accepting new patients
Nystrom & Associates Counseling Wi., S.C. CurrentSince Nov 11, 2024 Accepting new patients

Locations

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

201 Main St
Ste 500
La Crosse, WI 54601
Phone (608) 668-4005

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1073659801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MAIN ST STE 500",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546010716",
            "telephone_number": "608-668-4005",
            "fax_number": "608-668-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUIKEMA",
        "first_name": "JEFFREY",
        "middle_name": "KARL",
        "credential": "PHD, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4262",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "229-124",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.