Mark Alan Midthun, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

50549-020 Issued in WI

Practice address

3626 East Ave S Ste 2a
La Crosse, WI 54601-7221

Phone

(608) 787-6411

Fax

(608) 787-6414

NPI assigned

Nov 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

University of Iowa, RJ & L Carver College of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Mark a Midthun MD LLC

  • Psychiatry Physician
  • La Crosse, WI
  • NPI 1740830512
  Medicare reassignment NPD Authorized official
• State of South Dakota

  • Psychiatric Hospital
  • Yankton, SD
  • NPI 1124027586
  NPD (past)
• State of South Dakota

  • Audiologist
  • Vermillion, SD
  • NPI 1346366044
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1487721791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W6602 SCHILLING RD",
            "address_2": "UNIT C",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546509341",
            "telephone_number": "608-397-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3626 EAST AVE S STE 2A",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546017221",
            "telephone_number": "608-787-6411",
            "fax_number": "608-787-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDTHUN",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "49571",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SD",
            "license": "3717",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "50549-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael S Meyers, MD
• Mickenzie Meyers
• MH Imaging - la Crosse
• Mandy Mickelson, PTA
• Elizabeth Larson Middleton, PA
• Midwest Chiropractic Associates, S.C.
• Polly A Mihalovic, RD
• Amanda Agnes Milanowski
• Milla Transit LLC
• Lisa M Miller Schinke, MBA, RDN, CSR, LD

• Psychiatry Physician in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.

Verify at the official NPI Registry.