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Gundersen Lutheran Medical Center Inc

Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Prairie Du Chien, WI

NPI 1376886465 · NPPES record last updated Aug 31, 2026

Key facts

NPI
1376886465
Entity type
Organization (NPI type 2)
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
Legal business name
GUNDERSEN LUTHERAN MEDICAL CENTER INC
Practice address
610 E Taylor St
Prairie Du Chien, WI 53821-2109
Phone
(608) 782-7300
NPI assigned
Mar 27, 2013
Organization subpart
Yes
Parent organization (as reported)
GUNDERSEN LUTHERAN MEDICAL CENTER INC

Authorized official

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

Other NPIs on the same Medicare enrollment 1

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

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 26

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

View all 26

Practitioners 888

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 888

Affiliated clinicians 1

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

Medicare Care Compare: Dialysis facility

Listed as
Gundersen Lutheran Renal Dialysis - Prairie Du Chien CCN 523500
Overall star rating
★★★☆☆ 3.0 of 5
Ownership
Non-profit
Certified
Sep 27, 1986
Medicare certification status
Active (Provider of Services file)
Chain
Gundersen Lutheran
Dialysis stations
12

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040109000906 WI Part a Provider - End-Stage Renal Disease Facility (ESRD) 2163331414 1 other NPI on this enrollment
Practice locations: Prairie Du Chien, WI

National Provider Directory

Tax ID family
Lutheran HSP-la Crosse (27 organizations share this tax ID)
Part of
Lutheran HSP-la Crosse

Specialties & licenses

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

Addresses

Primary practice location

610 E Taylor St
Prairie Du Chien, WI 53821-2109

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
42051000MedicaidWI

Other names

  • Emplify Health Prairie du Chien Renal Dialysis Doing business as
  • GLMC PRAIRIE DU CHIEN RENAL DIALYSIS Other name

Other providers in Prairie Du Chien, WI

All providers in Prairie Du Chien, WI · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Wisconsin

Sources for this page

Verify at the official NPI Registry.