NPIMap

Individual provider Active NPI

Kathryn Bluske, PA-C

  • Medical Physician Assistant
  • La Crosse, WI
National Provider Identifier
1639493786
Registry record updated Sep 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3870 Issued in WI
Practice address
1836 South Ave
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
Mar 18, 2010
Last updated
Sep 29, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA00547 RI
Medical Physician Assistant 363AM0700X 3870 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

Other identifiers 5

IdentifierTypeStateIssuer
939025129OtherRIRI MEDICARE GROUP
0019171OtherRIRI MEDICARE
11232010OtherRIBCBSRI
12092010OtherRINHPRI
KB82936MedicaidRI

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
I20161012002929 WI Practitioner - Physician Assistant 9234328220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gundersen Clinic LTDGroup PAC ID 9638082779, 422 clinicians

Practice addresses (Care Compare)

1600 Main St
Onalaska, WI 54650-2838
Phone (608) 783-4681

1836 S Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3870WIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Express Care, Inc CurrentSince Oct 10, 2016 Accepting new patients
Gundersen Clinic, LTD CurrentSince Oct 10, 2016 Accepting new patients
Gundersen Lutheran Medical Center, Inc. Past Accepting new patients
Gundersen Lutheran Medical Center Inc Past Accepting new patients
Gundersen Clinic LTD Past Accepting new patients

Locations

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

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

2500 State Rd
#33
La Crosse, WI 54601
Phone (608) 385-5803

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: kbluske220869@direct.emplifyhealth.org

Organizations & group practices 5

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": "1268870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475107200000",
    "number": "1639493786",
    "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": "BLUSKE",
        "first_name": "KATHRYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-18",
        "last_updated": "2016-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "RI",
            "license": "PA00547",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "3870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI MEDICARE GROUP",
            "identifier": "939025129",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI MEDICARE",
            "identifier": "0019171",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSRI",
            "identifier": "11232010",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHPRI",
            "identifier": "12092010",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "KB82936",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.