NPIMap

Individual provider Active NPI

Leo Matthew Pedretti

  • Medical Physician Assistant
  • Onalaska, WI
National Provider Identifier
1114234580
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3463 Issued in WI
Practice address
3111 Gundersen Dr
Onalaska, WI 54650-8447
Phone
(608) 775-8100
NPI assigned
Sep 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1481 MN
Physician Assistant 363A00000X 10847 MN
Medical Physician Assistant 363AM0700X 3463 WI Primary

Addresses

Primary practice location

3111 Gundersen Dr
Onalaska, WI 54650-8447

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 MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101018000948 MN Practitioner - Physician Assistant 4284827676 Reassigns benefits to 1 organization
I20150205002020 WI Practitioner - Physician Assistant 4284827676 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gundersen Lutheran Medical Center IncGroup PAC ID 2163331414, shared by 16 NPIs, 888 clinicians

Practice addresses (Care Compare)

1122 W Hwy 61
Winona, MN 55987-1957
Phone (507) 615-0600

1910 S Ave
La Crosse, WI 54601-5467
Phone (608) 782-7300

3111 Gundersen Dr
Onalaska, WI 54650-8447
Phone (608) 782-7300

Hospital & facility affiliations

  • Gundersen Lutheran Medical Center Hospital, La Crosse, WI, CCN 520087

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10847MNMDPhysical Therapist
3463WIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Medical Center, Inc CurrentSince Mar 15, 2021 Accepting new patients
Gundersen Clinic, LTD CurrentSince Jan 5, 2015 Accepting new patients
Gundersen Lutheran Express Care, Inc CurrentSince Jan 5, 2015 Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Jul 30, 2025 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Mar 15, 2021 Accepting new patients
Gundersen Clinic, LTD. Past Accepting new patients
Gundersen Clinic LTD Past Accepting new patients
Gundersen Lutheran Medical Center Inc Past Accepting new patients

Locations

1122 W Highway 61
Winona, MN 55987
Phone (507) 615-0600

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

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

3111 Gundersen Dr
Onalaska, WI 54650
Phone (608) 775-8100

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

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

Interoperability endpoints

  • Direct secure messaging: lpedretti89060@direct.emplifyhealth.org

Organizations & group practices 9

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 7

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": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1114234580",
    "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": "3111 GUNDERSEN DR",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546508447",
            "telephone_number": "608-775-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDRETTI",
        "first_name": "LEO",
        "middle_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-08",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "1481",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10847",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "3463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Onalaska, WI

Sources for this page

Verify at the official NPI Registry.