NPIMap

Individual provider Active NPI

Ryan Michael Manz, MD

  • Facial Plastic Surgery Physician
  • La Crosse, WI
National Provider Identifier
1407028459
Registry record updated Nov 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
60945 Issued in WI
Practice address
1836 South Ave
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
Mar 31, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 57.012247 OH
Otolaryngology Physician 207Y00000X A121073 CA
Otolaryngology Physician 207Y00000X 60945 WI
Facial Plastic Surgery Physician 207YS0123X 60945 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
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131007000788 WI Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 7416108550 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
University of Wisconsin School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gundersen Lutheran Medical Center IncGroup PAC ID 2163331414, 888 clinicians

Practice addresses (Care Compare)

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

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

2575 S 7TH St
Bethany Riverside
La Crosse, WI 54601-5429
Phone (608) 775-8200

3111 Gundersen Dr
Onalaska, WI 54650-8447
Phone (608) 782-7300

Hospital & facility affiliations

  • Gundersen Lutheran Medical Center Hospital, La Crosse, WI, CCN 520087

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision85
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A121073CAMDOtolaryngology Physician
57.012247OHMDOtolaryngology Physician
60945WIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Clinic LTD CurrentSince Aug 1, 2013 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Aug 1, 2013 Accepting new patients
Gundersen Lutheran Express Care, Inc CurrentSince Aug 1, 2013 Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Aug 1, 2013 Accepting new patients
Gundersen Clinic LTD Current Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients

Locations

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

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

801 Critter Ct
Onalaska, WI 54650
Phone (608) 775-8152

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

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

Interoperability endpoints

  • Direct secure messaging: rmanz56999@direct.emplifyhealth.org

Organizations & group practices 6

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509667200000",
    "number": "1407028459",
    "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": "MANZ",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-31",
        "last_updated": "2017-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "57.012247",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A121073",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "60945",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "WI",
            "license": "60945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.