Individual provider Active NPI

Kerry Hyland Pischke, PT

  • Physical Therapist
  • La Crosse, WI
National Provider Identifier
1164661153
Registry record updated Apr 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11173 Issued in WI
Practice address
1836 South Ave
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
Feb 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11173 WI Primary
Physical Therapist 225100000X 10237 MN

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 names 1

  • Kerry A Hyland Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090422000493 WI Practitioner - Physical Therapist in Private Practice 4082761465 Reassigns benefits to 1 organization
I20161114000951 MN Practitioner - Physical Therapist in Private Practice 4082761465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gundersen Clinic LTDGroup PAC ID 9638082779, 422 clinicians

Practice addresses (Care Compare)

1836 S Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300

405 S
Suite 76
Caledonia, MN 55921-1308
Phone (608) 775-9989

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10237MNMDAdult Psychiatric/Mental Health Registered Nurse
11173WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Express Care, Inc CurrentSince Mar 2, 2009 Accepting new patients
Gundersen Clinic LTD Current Accepting new patients
Gundersen Clinic LTD Physical Therapist CurrentSince Nov 1, 2016 Accepting new patients
Gundersen Clinic LTD CurrentSince Mar 2, 2009 Accepting new patients
Gundersen Clinic, LTD. Past Accepting new patients

Locations

123 5th Ave SE
Spring Grove, MN 55974
Phone (507) 498-3302

402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331

1140 Main St
La Crosse, WI 54601
Phone (608) 519-5473

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

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

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

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1234483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460592000000",
    "number": "1164661153",
    "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": "PISCHKE",
        "first_name": "KERRY",
        "middle_name": "HYLAND",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-13",
        "last_updated": "2016-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "11173",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10237",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERRY",
            "last_name": "HYLAND",
            "middle_name": "A",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Apr 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.