NPIMap

Individual provider Active NPI

Jeremiah Kakes, MD

  • Family Medicine Physician
  • La Crosse, WI
National Provider Identifier
1710507918
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
75851-20 Issued in WI
Practice address
1836 South Ave
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
Apr 17, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 75851-20 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 practice location 1

617 W Clairemont Ave
Eau Claire, WI 54701-6223
Phone (715) 839-5175

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jkakes286334@ewd.direct.hshs.org Direct

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
I20220218000703 WI Practitioner - Family Practice 7810310174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1836 S Ave
La Crosse, WI 54601-5429
Phone (608) 783-7300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
75851-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Medical Center, Inc CurrentSince Oct 2, 2023 Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Oct 2, 2023 Accepting new patients
Prevea Clinic, Inc. Family Medicine Current Accepting new patients
Gundersen Lutheran Medical Center Inc Past Accepting new patients

Locations

617 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 834-2788

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

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

710 Denton St
La Crosse, WI 54601
Phone (608) 775-6680

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

Interoperability endpoints

  • Direct secure messaging: jkakes666978@direct.emplifyhealth.org
  • Direct secure messaging: jkakes286334@ewd.direct.hshs.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 and National Provider Directory roles.

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": "1587081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1710507918",
    "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": [
        {
            "address_1": "617 W Clairemont Ave",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547016223",
            "country_code": "US",
            "telephone_number": "715-839-5175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAKES",
        "first_name": "JEREMIAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-17",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "75851-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkakes286334@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "617 W Clairemont Ave",
            "city": "Eau Claire",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547016223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.