Garrett J Wickman

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

587423 Issued in WI

Practice address

1836 South Ave
La Crosse, WI 54601-5429

Phone

(608) 782-7300

NPI assigned

Mar 21, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI, MN, IA3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gwickman659656@direct.emplifyhealth.org

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.

• Memorial Hospital of Boscobel

  • Critical Access Hospital
  • Boscobel, WI
  • NPI 1760459846
  Medicare reassignment NPD
• Moundview Memorial Hospital & Clinics, Inc

  • Critical Access Hospital
  • Friendship, WI
  • NPI 1710939533
  Medicare reassignment NPD
• Palmer Lutheran Health Center, Inc.

  • Critical Access Hospital
  • West Union, IA
  • NPI 1891744108
  Medicare reassignment NPD
• Saint Elizabeths Hospital of Wabasha Inc

  • Critical Access Hospital
  • Wabasha, MN
  • NPI 1659355600
  Medicare reassignment NPD
• Gundersen Lutheran Medical Center Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1225873458
  Medicare reassignment
• St. Joseph'S Health Services, Inc.

  • Clinic/Center
  • Hillsboro, WI
  • NPI 1104031798
  Medicare reassignment
• Tri-County Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Whitehall, WI
  • NPI 1417201864
  Medicare reassignment
• Gundersen Lutheran Medical Center, Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1619210895
  NPD
• Gundersen Lutheran Medical Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Onalaska, WI
  • NPI 1871837567
  NPD
• Memorial Hospital of Boscobel

  • Medicare Defined Swing Bed Hospital Unit
  • Boscobel, WI
  • NPI 1497712624
  NPD
• Moundview Memorial Hospital & Clinics, Inc.

  • Clinic Pharmacy
  • Friendship, WI
  • NPI 1669056693
  NPD
• St. Joseph'S Health Services, Inc.

  • Clinic/Center
  • Elroy, WI
  • NPI 1699788273
  NPD

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

{
    "created_epoch": "1616284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1285210229",
    "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": "WICKMAN",
        "first_name": "GARRETT",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-21",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "WI",
            "license": "70110491",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "587423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua John Whitson, DO
• Brett S Whyte, MD
• Heather Jo Wichman, M.D.
• Paula J Wickersham, PA
• Patricia A Wickert, APNP
• Mark C Wickre, MD
• Erik Wickstrom
• Kayla Wiedenbeck, MS, CCC-SLP
• Christina Renee Wiedenhoeft, MD
• Karmen Wielunski, D.O.

• Medical Physician Assistant in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Medical Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.