NPIMap

Organization Active NPI

Gundersen Lutheran Medical Center Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • La Crosse, WI
National Provider Identifier
1205598570
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
GUNDERSEN LUTHERAN MEDICAL CENTER INC
Practice address
1910 South Ave
Heritage Building 2 West
La Crosse, WI 54601-5467
Phone
(608) 782-7300
Fax
(608) 775-4432
NPI assigned
Oct 13, 2021
Organization subpart
Yes
Parent organization
GUNDERSEN LUTHERAN MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Authorized official

Name
Debra L Van Pay
Title
Director, Reimbursement
Phone
(920) 436-8628

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

1910 South Ave
Heritage Building 2 West
La Crosse, WI 54601-5467

Mailing address

1910 South Ave
La Crosse, WI 54601-5467
Phone (608) 782-7300

Other names 1

  • Emplify Health La Crosse Renal Dialysis Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050512000319 WI Part A Provider - End-Stage Renal Disease Facility (ESRD) 2163331414 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: La Crosse, WI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Gundersen Lutheran Renal Dialysis - la CrosseCCN 522313
Ownership
Non-profit
Certified
Sep 1, 1977
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Gundersen Lutheran
Dialysis stations
12

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory
Tax ID family
Lutheran HSP-la Crosse27 organizations share this tax ID, including this one
Part of
Lutheran HSP-la Crosse

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Locations

1910 South Ave
Bldg 2
La Crosse, WI 54601

Practitioners & affiliated clinicians

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788134400000",
    "number": "1205598570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015467",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 SOUTH AVE",
            "address_2": "HERITAGE BUILDING 2 WEST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015467",
            "telephone_number": "608-782-7300",
            "fax_number": "608-775-4432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUNDERSEN LUTHERAN MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GUNDERSEN LUTHERAN MEDICAL CENTER INC",
        "enumeration_date": "2021-10-13",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A",
        "authorized_official_last_name": "VAN PAY",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR, REIMBURSEMENT",
        "authorized_official_telephone_number": "920-436-8628"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emplify Health La Crosse Renal Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 31, 2026; 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.