NPIMap

Individual provider Active NPI

Fatemeh S Jannati

  • Podiatrist
  • La Crosse, WI
National Provider Identifier
1174878706
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1045 Issued in WI
Practice address
1836 South Ave
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
Jul 19, 2012
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 1045 WI Primary
Foot & Ankle Surgery Podiatrist 213ES0103X 17806-875 WI

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

2500 Overlook Ter
Madison, WI 53705-2254
Phone (608) 256-1901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160216002415 WI Practitioner - Podiatry 8729204789 Reassigns benefits to 5 organizations
I20210304001857 MN Practitioner - Podiatry 8729204789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 Grant Blvd W
Wabasha, MN 55981-1042
Phone (651) 565-4531

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

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue40
Removal of skin lesions29
Removal of nail tissue337
Removal or shaving of skin growth65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1045WIMDPodiatrist
17806-875WIMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Express Care, Inc CurrentSince Jan 29, 2018 Accepting new patients
Tri-County Memorial Hospital, Inc. CurrentSince Jan 29, 2018 Accepting new patients
St. Joseph's Health Services, Inc. CurrentSince Feb 15, 2018 Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Jan 29, 2018 Accepting new patients
Tri-County Memorial Hospital, Inc. CurrentSince Jan 29, 2018 Accepting new patients
Prairie Du Chien Memorial Hospital Association Inc CurrentSince Apr 25, 2016 Accepting new patients
Saint Elizabeths Hospital of Wabasha Inc CurrentSince Mar 20, 2021 Accepting new patients
St. Joseph's Health Services, Inc. CurrentSince Feb 15, 2018 Accepting new patients
Prairie Du Chien Memorial Hospital Assoc Inc CurrentSince Apr 25, 2016 Accepting new patients
Gundersen Clinic LTD CurrentSince Jan 29, 2018 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Jan 29, 2018 Accepting new patients
Saint Elizabeths Hospital of Wabasha Inc CurrentSince Mar 20, 2021 Accepting new patients
Gundersen Lutheran Medical Center, Inc. Past Accepting new patients
The Psychology Center S C Past Accepting new patients

Locations

1200 Grant Blvd W
Wabasha, MN 55981
Phone (651) 565-4531

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

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

37868 US Highway 18
Prairie du Chien, WI 53821
Phone (608) 357-2000

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

1111 W Wisconsin St
Sparta, WI 54656
Phone (608) 269-1588

18601 Lincoln St
Whitehall, WI 54773
Phone (715) 538-1712

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 15

Hospital & facility affiliations 8

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": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1174878706",
    "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": "2500 Overlook Ter",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537052254",
            "country_code": "US",
            "telephone_number": "608-256-1901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANNATI",
        "first_name": "FATEMEH",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WI",
            "license": "1045",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WI",
            "license": "17806-875",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.