NPIMap

Individual provider Active NPI

Micca Donohue, M.D.

  • Obstetrics & Gynecology Physician
  • Onalaska, WI
National Provider Identifier
1629288048
Registry record updated Jun 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
50486-020 Issued in WI
Practice address
3111 Gundersen Dr
Onalaska, WI 54650-8447
Phone
(608) 782-7300
NPI assigned
May 23, 2007
Last updated
Jun 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 50486-020 WI Primary
Obstetrics & Gynecology Physician 207V00000X R-7051 IA

Addresses

Primary practice location

3111 Gundersen Dr
Onalaska, WI 54650-8447

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
I20070919000776 WI Practitioner - Obstetrics/Gynecology 9234223371 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Iowa, RJ & L Carver College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gundersen Clinic LTDGroup PAC ID 9638082779, 422 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

610 E Taylor St
PR Du Chien, WI 53821-2109
Phone (608) 326-6466

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-7051IAMDObstetrics & Gynecology Physician
50486-020WIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Express Care, Inc CurrentSince Aug 1, 2013 Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Jun 1, 2013 Accepting new patients
Memorial Hospital of Boscobel CurrentSince Aug 1, 2015 Accepting new patients
Memorial Hospital of Boscobel CurrentSince Aug 1, 2015 Accepting new patients
Gundersen Clinic LTD CurrentSince Aug 1, 2013 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Jun 1, 2013 Accepting new patients
Gundersen Lutheran Medical Center, Inc. Past Accepting new patients

Locations

205 Parker St
Boscobel, WI 53805
Phone (608) 375-4112

402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331

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

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

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

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

610 E Taylor St
Prairie du Chien, WI 53821
Phone (608) 326-6466

Interoperability endpoints

  • Direct secure messaging: mdonohue7730@direct.emplifyhealth.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1629288048",
    "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": "3111 GUNDERSEN DR",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546508447",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOHUE",
        "first_name": "MICCA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "50486-020",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IA",
            "license": "R-7051",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Onalaska, WI

Sources for this page

Verify at the official NPI Registry.