Mark James Erickson, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

7230 Issued in WI

Practice address

1836 South Ave
La Crosse, WI 54601

Phone

(608) 782-7300

NPI assigned

Apr 23, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI, MN3 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 3

Specialty

Dentist

Education

Marquette University School of Dentistry, 2012

Medicare assignment

May accept Medicare assignment

Group practices

Gundersen Clinic LTDGroup PAC ID 9638082779, 422 clinicians

Northern Oral and Maxillofacial Surgeons PAGroup PAC ID 3072535863, shared by 2 NPIs, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: merickson79772@direct.emplifyhealth.org

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.

• Gundersen Clinic LTD

  • Clinic/Center
  • La Crosse, WI
  • NPI 1851343115

  MN

  Medicare reassignment Care Compare group NPD
• Northern Oral & Maxillofacial Surgeons, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Superior, WI
  • NPI 1013068691
  Medicare reassignment
• Northern Oral & Maxillofacial Surgeons, PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Duluth, MN
  • NPI 1457401820
  Medicare reassignment
• Gundersen Lutheran Express Care, Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1043446974
  NPD
• Gundersen Clinic, LTD.

  • Clinic/Center
  • Calmar, IA
  • NPI 1306890959
  NPD (past)

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

• Gundersen Lutheran Medical Center Inc

  • General Acute Care Hospital
  • La Crosse, WI
  • NPI 1376593442
  Care Compare affiliation
• Gundersen Lutheran Medical Center Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1790646719

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center, Inc

  • Clinic/Center
  • Onalaska, WI
  • NPI 1225372923

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center, Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1497090138

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Onalaska, WI
  • NPI 1871837567

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center, Inc.

  • Air Ambulance
  • La Crosse, WI
  • NPI 1467468173

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center Inc

  • Clinic/Center
  • Winona, MN
  • NPI 1952959603

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1144587551",
    "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": "54601",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "MARK",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-23",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "7230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce B Erdmann, DPM
• Kimberly K Erickson Nichols, MS APSW LPC
• Amanda Jean Erickson, MS, LPC
• Jessica M Erickson, RDH
• John E Erickson Jr., CRNA
• Robin Lyn Erickson
• Tori Erickson, RDN
• Jay C Erie, M.D.
• Jennifer Erin, CRNA
• Martin Erlandson, DO

• Oral and Maxillofacial Surgery (Dentist) in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.