NPIMap

Individual provider Active NPI

Travis Jon Smith, MD

  • Surgery Physician
  • La Crosse, WI
National Provider Identifier
1740443803
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
52055 Issued in WI
Practice address
1836 South Ave
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
Jul 8, 2008
Last updated
Aug 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X 52055 WI
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 52055 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, IA, MN3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20130814000735 WI Practitioner - General Surgery 5799941506 Reassigns benefits to 6 organizations
I20200923001290 IA Practitioner - General Surgery 5799941506 Reassigns benefits to 1 organization
I20230926002923 MN Practitioner - General Surgery 5799941506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Mayo Medical School, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gundersen Lutheran Medical Center IncGroup PAC ID 2163331414, shared by 16 NPIs, 888 clinicians

Practice addresses (Care Compare)

1122 W Hwy 61
Winona, MN 55987-1957
Phone (507) 615-0600

1910 S Ave
La Crosse, WI 54601-5467
Phone (608) 782-7300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
52055WIMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Express Care, Inc CurrentSince Jan 10, 2018 Accepting new patients
Prairie Ridge Health, Inc. Surgery CurrentSince Jun 18, 2020 Accepting new patients
Prairie Ridge Health, Inc. Current Accepting new patients
Tomah Memorial Hospital Inc CurrentSince Jan 1, 2023 Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Delaware County Memorial Hospital CurrentSince Oct 16, 2020 Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Jul 29, 2013 Accepting new patients
Memorial Hospital of Boscobel CurrentSince Mar 27, 2018 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc. CurrentSince May 1, 2018 Accepting new patients
Delaware County Memorial Hospital CurrentSince Oct 16, 2020 Accepting new patients
Prairie Ridge Health Inc. CurrentSince Jun 18, 2020 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc CurrentSince May 1, 2018 Accepting new patients
Memorial Hospital of Boscobel CurrentSince Mar 27, 2018 Accepting new patients
Gundersen Clinic LTD CurrentSince Jan 10, 2018 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Jul 29, 2013 Accepting new patients
Delaware County Memorial Hospital Current Accepting new patients
Tomah Memorial Hospital Inc Surgery CurrentSince Jan 1, 2023 Accepting new patients

Locations

709 W Main St
Manchester, IA 52057
Phone (563) 927-3232

1122 W Highway 61
Winona, MN 55987
Phone (507) 615-0600

610 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-4311

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

1515 Park Ave
Columbus, WI 53925
Phone (920) 623-1200

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

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

501 Gopher Dr
Tomah, WI 54660
Phone (608) 371-2181

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/a87187e5-fe2f-447e-bf32-4eeb3954a735/
  • Direct secure messaging: tsmith10584@direct.emplifyhealth.org
  • Direct secure messaging: tsmith758435@direct.emplifyhealth.org

Organizations & group practices 17

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 17

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": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1740443803",
    "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": "SMITH",
        "first_name": "TRAVIS",
        "middle_name": "JON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-08",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "WI",
            "license": "52055",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "52055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.