Stefan Michael Brettfeld, D.O.
Individual provider Active NPI Anatomic Pathology & Clinical Pathology Physician · La Crosse, WI
NPI 1154718005 · NPPES record last updated Jul 29, 2020
Key facts
- NPI
- 1154718005
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
- License
- 94-321 (WI)
- Practice address
- 1836 South Ave
La Crosse, WI 54601-5429 - Phone
- (608) 782-7300
- NPI assigned
- Apr 17, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 57
Hospital & facility affiliations 10
Medicare Care Compare profile
- Specialty
- Pathology
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Gundersen Lutheran Medical Center Inc
Saint Elizabeths Hospital of Wabasha Inc
Tri-County Memorial Hospital Inc
Prairie Du Chien Memorial Hospital Association Inc
Vernon Memorial Healthcare Inc
Practice addresses (Care Compare)
1836 S Ave
La Crosse, WI 54601-5429
Phone (608) 783-7300
18601 Lincoln St
Whitehall, WI 54773-8605
Phone (715) 538-4361
1910 S Ave
La Crosse, WI 54601-5467
Phone (608) 782-7300
2575 S 7TH St
Bethany Riverside
La Crosse, WI 54601-5429
Phone (608) 775-8200
37868 US Hwy 18
Prairie Du Chien, WI 53821-8416
Phone (608) 357-2000
507 S Main St
Viroqua, WI 54665-2059
Phone (608) 637-2101
Hospital & facility affiliations
- Gundersen Lutheran Medical Center
- St Elizabeth Medical Center
- Vernon Memorial Hospital
- Gundersen St Josephs Hospital and Clinics
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IA, WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200730003525 | IA | Practitioner - Pathology | 2668786583 | Reassigns benefits to 3 organizations |
| I20200806001022 | WI | Practitioner - Pathology | 2668786583 | Reassigns benefits to 14 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65094 | MN | MD | Anatomic Pathology & Clinical Pathology Physician |
| 94-321 | WI | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
Locations
120 2nd Ave SE
Waukon, IA 52172
Phone (563) 568-3000
40 1st St SE
Waukon, IA 52172
Phone (563) 568-3411
112 Jefferson St
West Union, IA 52175
Phone (563) 422-3811
1200 Grant Blvd W
Wabasha, MN 55981
Phone (651) 565-4531
205 Parker St
Boscobel, WI 53805
Phone (608) 375-4112
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
610 E Taylor St
Prairie du Chien, WI 53821
Phone (608) 326-6466
37868 US Highway 18
Prairie du Chien, WI 53821
Phone (608) 357-2000
501 Gopher Dr
Tomah, WI 54660
Phone (608) 371-2181
505 Gopher Dr
Tomah, WI 54660
Phone (608) 372-2181
507 S Main St
Viroqua, WI 54665
Phone (608) 637-2101
407 S Main St
Viroqua, WI 54665
Phone (608) 637-3195
18601 Lincoln St
Whitehall, WI 54773
Phone (715) 538-1712
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 65094 | MN | |
| Student in an Organized Health Care Education/Training Program | 390200000X | R-13-2015 | NM | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 94-321 | WI | Yes |
Addresses
Primary practice location
1836 South Ave
La Crosse, WI 54601-5429
Mailing address
1836 South Ave
La Crosse, WI 54601-5429
Other practice location 1
MSC 07-4040
1 University of New Mexico
Albuquerque, NM 87131
Phone (505) 272-3053
Other practice location 2
MSC 07-4040
1 University of New Mexico
Albuquerque, NM 87131
Phone (505) 272-3053
Other practice location 3
200 1st St SW
Rochester, MN 55905
Phone (507) 284-2511
Other providers in La Crosse, WI
- Samantha Lynne Brecht
- Breidenbach Family and Sports Chiropractic Inc
- Jewell Marie Breitengross
- Emily Marie Bresette
- Landon Bresina
- Anton Thies Breunig
- Ayesha Lundi Breunig
- Richard Brewer
- Karen L Briggs
- Samuel Vincent Brill
All providers in La Crosse, WI · Anatomic Pathology & Clinical Pathology Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.