Individual provider Active NPI

Samuel Otto Wetzel, OD

  • Optometrist
  • La Crosse, WI
National Provider Identifier
1215826649
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4082 Issued in WI
Practice address
1836 South Ave
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
Jul 1, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4082 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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250827002285 WI Practitioner - Optometry 3375044951 Reassigns benefits to 2 organizations
I20260403001288 IA Practitioner - Optometry 3375044951 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gundersen Clinic LTDGroup PAC ID 9638082779, 422 clinicians
Gundersen Lutheran Medical Center IncGroup PAC ID 2163331414, 888 clinicians

Practice addresses (Care Compare)

1830 State Hwy 9
Decorah, IA 52101-7301
Phone (563) 382-3140

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

505 Gopher Dr
Tomah, WI 54660-4513
Phone (608) 372-4111

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4082WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Medical Center Inc CurrentSince Sep 2, 2025 Accepting new patients
Gundersen Lutheran Express Care, Inc CurrentSince Sep 2, 2025 Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Sep 2, 2025 Accepting new patients
Gundersen Clinic LTD CurrentSince Sep 2, 2025 Accepting new patients
Gundersen Clinic, LTD. Past Accepting new patients

Locations

1830 State Highway 9
Ste 100
Decorah, IA 52101
Phone (563) 382-3140

1830 State Highway 9
Decorah, IA 52101
Phone (563) 382-2639

1122 W Highway 61
Winona, MN 55987
Phone (507) 615-0600

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

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

724 Denton St
La Crosse, WI 54601
Phone (608) 775-1000

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

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

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

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

505 Gopher Dr
Tomah, WI 54660
Phone (608) 372-2181

Interoperability endpoints

  • Direct secure messaging: swetzel1128758@direct.emplifyhealth.org

Organizations & group practices 7

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": "1751328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1215826649",
    "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": "WETZEL",
        "first_name": "SAMUEL",
        "middle_name": "OTTO",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-01",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "4082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.