Jacob David Bentley, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

81583 Issued in WI

Practice address

1836 South Ave
La Crosse, WI 54601-5429

Phone

(608) 782-7300

NPI assigned

Apr 13, 2021

Last updated

Sep 20, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saint Elizabeths Hospital of Wabasha IncGroup PAC ID 5092619387, 93 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Elizabeth Medical Center Hospital, Wabasha, MN, CCN 241335
• St Elizabeth Medical Center Nursing home, CCN 24Z335

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbentley521966@direct.emplifyhealth.org

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.

• Saint Elizabeths Hospital of Wabasha Inc

  dba Gundersen St. Elizabeth's Hospital and Clinics

  • Critical Access Hospital
  • Wabasha, MN
  • NPI 1659355600

  WI

  Medicare reassignment Care Compare group NPD
• Gundersen Lutheran Medical Center Inc

  dba Emplify Health Hamilton Clinic

  • Clinic/Center
  • La Crosse, WI
  • NPI 1225873458
  Medicare reassignment NPD
• Gundersen Lutheran Medical Center, Inc

  dba Emplify Health Onalaska Clinic

  • Clinic/Center
  • Onalaska, WI
  • NPI 1225372923
  NPD
• Gundersen Lutheran Medical Center, Inc

  dba Emplify Health Onalaska Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Onalaska, WI
  • NPI 1871837567
  NPD
• Saint Elizabeths Hospital of Wabasha Inc

  dba Gundersen St. Elizabeth's Hospital and Clinics

  • Clinic/Center
  • Wabasha, MN
  • NPI 1073050274
  NPD
• Saint Elizabeths Hospital of Wabasha Inc

  dba Gundersen Pharmacy

  • Community/Retail Pharmacy
  • Wabasha, MN
  • NPI 1912334913
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Elizabeths Hospital of Wabasha Inc

  dba Gundersen St. Elizabeth's Hospital and Clinics

  • Critical Access Hospital
  • Wabasha, MN
  • NPI 1659355600
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1720668692",
    "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": "BENTLEY",
        "first_name": "JACOB",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-13",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "75255",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "81583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Carmen Benkers, PA
• Karen V Bennett, RD
• Ashlyn Jan Bennin
• Sonja Beth Benrud, BA PSYCHOLOGY
• Joshua James Bensen, MD
• David Bentz
• Jane Benzschawel, APSW
• Cameron Lyn Beran
• Makayla Sheajon Beran
• Gabriel T. Berendes, MD

• Family Medicine Physician in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.