Individual provider Active NPI

Tara Sova, PA-C

  • Surgical Physician Assistant
  • La Crosse, WI
National Provider Identifier
1184966368
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
7250 Issued in WI
Practice address
1836 South Ave Ste 201
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
Mar 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgical Physician Assistant 363AS0400X 7250 WI Primary
Physician Assistant 363A00000X PA169296 OR

Addresses

Primary practice location

1836 South Ave Ste 201
La Crosse, WI 54601-5429

Mailing address

1836 South Ave Ste 201
La Crosse, WI 54601-5429
Phone (608) 782-7300

Other identifiers 2

IdentifierTypeStateIssuer
500676956MedicaidOR
P01483730OtherORRR MEDICARE (PH&S)

Other names 1

  • Tara Bittner Former name

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address tsova422823@oc.providencedirect.org
Direct Messaging Address tsova422823@oc.providencedirect.org
Direct Messaging Address tsova422823@oc.providencedirect.org
Direct Messaging Address tsova422823@oc.providencedirect.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230509001576 WI Practitioner - Physician Assistant 4082834221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Oregon Health Sciences University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gundersen Lutheran Medical Center IncGroup PAC ID 2163331414, 888 clinicians

Practice addresses (Care Compare)

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

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

Hospital & facility affiliations

  • Gundersen Lutheran Medical Center Hospital, La Crosse, WI, CCN 520087
  • Gundersen Boscobel Area Hospital and Clinics Hospital, Boscobel, WI, CCN 521344
  • Gundersen Moundview Hospital and Clinics Hospital, Friendship, WI, CCN 521309
  • Gundersen Tri-County Hospital & Clinics Hospital, Whitehall, WI, CCN 521316
  • Winona Health Services Hospital, Winona, MN, CCN 240044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
7250WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Medical Center Inc CurrentSince May 1, 2023 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince May 1, 2023 Accepting new patients
Gundersen Lutheran Medical Center Inc Past Accepting new patients

Locations

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

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

1836 South Ave
Ste 201
La Crosse, WI 54601

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

Interoperability endpoints

  • Direct secure messaging: tsova422823@oc.providencedirect.org
  • Direct secure messaging: tsova25679@direct.emplifyhealth.org

Organizations & group practices 4

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1184966368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE STE 201",
            "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 STE 201",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOVA",
        "first_name": "TARA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-26",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "7250",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA169296",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500676956",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE (PH&S)",
            "identifier": "P01483730",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tsova422823@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1111 NE 99th Avenue",
            "address_2": "SUITE 201",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tsova422823@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "10330 SE 32nd Ave Ste 210",
            "city": "Milwaukie",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972226594",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tsova422823@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1510 Division St Ste 100",
            "city": "Oregon City",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970451572",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tsova422823@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "440 NW Division St",
            "city": "Gresham",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970305506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "BITTNER",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.