Active NPI
Jackson Lewison
- Surgical Physician Assistant
- Winona, MN
National Provider Identifier
1609723758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- Practice address
- 855 Mankato Ave
Winona, MN 55987-4868 - Phone
- (507) 454-3650
- NPI assigned
- Mar 16, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | Primary |
Addresses
Primary practice location
855 Mankato Ave
Winona, MN 55987-4868
Mailing address
1300 Badger St
La Crosse, WI 54601-1502
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1773619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773619200000",
"number": "1609723758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 BADGER ST",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546011502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 MANKATO AVE",
"city": "WINONA",
"state": "MN",
"postal_code": "559874868",
"telephone_number": "507-454-3650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWISON",
"first_name": "JACKSON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-03-16",
"last_updated": "2026-03-16",
"certification_date": "2026-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winona, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; 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.