NPIMap

Individual provider Active NPI

Jason T Collins

  • Surgery Physician
  • La Crosse, WI
National Provider Identifier
1679004733
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
76700 Issued in WI
Practice address
1836 South Ave
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
Mar 21, 2017
Last updated
Sep 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 76700 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
I20220920001695 WI Practitioner - General Surgery 3072998566 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Alabama College of Osteopathic Medicine, 2017
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)

505 Gopher Dr
Tomah, WI 54660-4513
Phone (608) 372-4111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy38
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux13
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76700WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Express Care, Inc CurrentSince Aug 22, 2022 Accepting new patients
Tri-County Memorial Hospital, Inc. CurrentSince Jan 14, 2026 Accepting new patients
St. Joseph's Health Services, Inc. Current Accepting new patients
Tri-County Memorial Hospital, Inc. CurrentSince Jan 14, 2026 Accepting new patients
St. Joseph's Health Services, Inc. CurrentSince Apr 14, 2023 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc. CurrentSince Jan 3, 2023 Accepting new patients
St. Joseph's Health Services, Inc. CurrentSince Apr 14, 2023 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc CurrentSince Jan 10, 2026 Accepting new patients
Gundersen Clinic LTD CurrentSince Aug 22, 2022 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc. CurrentSince Jan 3, 2023 Accepting new patients
Gundersen Lutheran Medical Center, Inc. Past Accepting new patients
St. Joseph's Health Services, Inc. Past Accepting new patients

Locations

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

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

1111 W Wisconsin St
Sparta, WI 54656
Phone (608) 269-1588

505 Gopher Dr
Tomah, WI 54660
Phone (608) 372-2181

18601 Lincoln St
Whitehall, WI 54773
Phone (715) 538-1712

Interoperability endpoints

  • Direct secure messaging: jcollins551174@direct.emplifyhealth.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 8

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": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1679004733",
    "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": "COLLINS",
        "first_name": "JASON",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-21",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "76700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.