Active NPI
Michael Patrick Sytsma, DO
- Emergency Medicine Physician
- La Crosse, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 54549
- Practice address
- 1836 South Ave
La Crosse, WI 54601-5429 - Phone
- (608) 782-7300
- NPI assigned
- Sep 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 5101015330 | MI | |
| Emergency Medicine Physician | 207P00000X | 54549 | 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
Other practice location 1
321 Butts Ave
Tomah, WI 54660-1412
Phone (608) 372-2181
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11-4789872 | Medicaid | MI |
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: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54549 | WI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gundersen Lutheran Medical Center Inc | Current | Accepting new patients | |
| Tomah Memorial Hospital Inc | Current | Accepting new patients | |
| Gundersen Clinic LTD | Current | Accepting new patients | |
| Gundersen Lutheran Express Care, Inc | Current | Accepting new patients | |
| Tomah Memorial Hospital Inc | Emergency Medicine | Current | Accepting new patients |
| Gundersen Lutheran Medical Center Inc | Current | Accepting new patients | |
| Gundersen Lutheran Medical Center, Inc | Current | Accepting new patients | |
| Tomah Memorial Hospital Inc | Current | Accepting new patients | |
| Gundersen Clinic, LTD. | Current | Accepting new patients | |
| Gundersen Clinic, LTD. | Past | Accepting new patients | |
| Shorepointe Emergency Care Physicians PC | Past | Accepting new patients |
Locations
402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331
1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287
1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102
1600 Main St
Onalaska, WI 54650
Phone (608) 783-4681
321 Butts Ave
Tomah, WI 54660
Phone (608) 372-2181
505 Gopher Dr
Tomah, WI 54660
Phone (608) 372-2181
501 Gopher Dr
Tomah, WI 54660
Phone (608) 371-2181
Interoperability endpoints
- msytsma75138@direct.emplifyhealth.org
Organizations & group practices 11
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.
-
- Clinic/Center
- La Crosse, WI
- NPI 1851343115
-
- Clinic/Center
- La Crosse, WI
- NPI 1225873458
-
- Critical Access Hospital
- Tomah, WI
- NPI 1184765240
-
- Clinic/Center
- Tomah, WI
- NPI 1497708044
-
- Clinic/Center
- La Crosse, WI
- NPI 1043446974
-
- General Acute Care Hospital
- La Crosse, WI
- NPI 1376593442
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Onalaska, WI
- NPI 1871837567
-
- Medicare Defined Swing Bed Hospital Unit
- Tomah, WI
- NPI 1205978046
-
- Clinic/Center
- Calmar, IA
- NPI 1306890959
-
- Emergency Medical Services (Emergency Medicine) Physician
- Grosse Pointe Farms, MI
- NPI 1043296296
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532044800000",
"number": "1164525036",
"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": [
{
"address_1": "321 Butts Ave",
"address_purpose": "LOCATION",
"city": "Tomah",
"state": "WI",
"postal_code": "546601412",
"country_code": "US",
"telephone_number": "608-372-2181",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SYTSMA",
"first_name": "MICHAEL",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2018-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MI",
"license": "5101015330",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WI",
"license": "54549",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "11-4789872",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in La Crosse, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.