Individual provider Active NPI

Marissa Ann Garrels Kjos, OD

  • Optometrist
  • La Crosse, WI
National Provider Identifier
1164311320
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4085 Issued in WI
Practice address
1836 South Ave
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
Jul 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4085 WI Primary

Addresses

Primary practice location

1836 South Ave
La Crosse, WI 54601-5429

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, IA, MN3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20250825001368 WI Practitioner - Optometry 6507366432 Reassigns benefits to 2 organizations
I20250828002873 IA Practitioner - Optometry 6507366432 Reassigns benefits to 1 organization
I20250903003597 MN Practitioner - Optometry 6507366432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2025
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
Gundersen Clinic LTDGroup PAC ID 9638082779, 422 clinicians

Practice addresses (Care Compare)

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

120 2ND Ave SE
Waukon, IA 52172-2073
Phone (563) 568-3000

1836 S Ave
La Crosse, WI 54601-5429
Phone (608) 783-7300

610 E Taylor St
PR Du Chien, WI 53821-2109
Phone (608) 326-6466

Hospital & facility affiliations

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4085WIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Medical Center Inc CurrentSince Aug 18, 2025 Accepting new patients
Gundersen Clinic LTD CurrentSince Sep 8, 2025 Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Aug 18, 2025 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Aug 18, 2025 Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Gundersen Clinic LTD CurrentSince Aug 18, 2025 Accepting new patients
Gundersen Lutheran Express Care, Inc CurrentSince Aug 18, 2025 Accepting new patients

Locations

1830 State Highway 9
Decorah, IA 52101
Phone (563) 382-2639

120 2nd Ave SE
Waukon, IA 52172
Phone (563) 568-3000

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

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

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

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

610 E Taylor St
Prairie du Chien, WI 53821
Phone (608) 326-6466

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

Interoperability endpoints

  • Direct secure messaging: mgarrelskjos1128016@direct.emplifyhealth.org

Organizations & group practices 7

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": "1751328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1164311320",
    "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": "546015429",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRELS KJOS",
        "first_name": "MARISSA",
        "middle_name": "ANN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-01",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "4085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.