Active NPI
Melissa Kathleen Johnson, MD
- Surgery Physician
- La Crosse, WI
National Provider Identifier
1265489181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 72696-20
- Practice address
- 1836 South Ave
La Crosse, WI 54601-5429 - Phone
- (608) 782-7300
- NPI assigned
- May 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 125043239 | IL | |
| Surgery Physician | 208600000X | 5904 | SD | |
| Surgery Physician | 208600000X | 72696 | WI | |
| Surgery Physician | 208600000X | 72696-20 | 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
Other names 1
- Ms. Melissa Kathleen Thompson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Gundersen Lutheran Medical Center Inc
Practice addresses (Care Compare)
1122 W Hwy 61
Winona, MN 55987-1957
Phone (507) 615-0600
1836 S Ave
La Crosse, WI 54601-5429
Phone (608) 783-7300
Hospital & facility affiliations
- Gundersen Lutheran Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 1-10 |
| Mastectomy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125043239 | IL | MD | Surgery Physician |
| 5904 | SD | MD | Surgery Physician |
| 72696 | WI | MD | Surgery Physician |
| 72696-20 | WI | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gundersen Lutheran Medical Center Inc | Current | Accepting new patients | |
| Gundersen Lutheran Medical Center, Inc | Current | Accepting new patients | |
| Gundersen Lutheran Medical Center Inc | Current | Accepting new patients | |
| Sanford Clinic | Past | Accepting new patients |
Locations
1122 W Highway 61
Winona, MN 55987
Phone (507) 615-0600
1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102
1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287
Interoperability endpoints
- mjohnson318164@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.
-
- Clinic/Center
- La Crosse, WI
- NPI 1225873458
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Onalaska, WI
- NPI 1871837567
-
- Diagnostic Radiology Physician
- Fargo, ND
- NPI 1306641345
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- La Crosse, WI
- NPI 1376593442
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Onalaska, WI
- NPI 1871837567
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584057600000",
"number": "1265489181",
"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": "JOHNSON",
"first_name": "MELISSA",
"middle_name": "KATHLEEN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-27",
"last_updated": "2020-03-13",
"certification_date": "2020-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "125043239",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "SD",
"license": "5904",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WI",
"license": "72696",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WI",
"license": "72696-20",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MELISSA",
"last_name": "THOMPSON",
"middle_name": "KATHLEEN",
"prefix": "MS.",
"code": "5",
"type": "Other 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 Mar 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.