NPIMap

Organization Active NPI

Memorial Hospital of Boscobel

Doing business as Gundersen Boscobel Area Hospital and Clinics

  • Critical Access Hospital
  • Boscobel, WI
National Provider Identifier
1760459846
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
MEMORIAL HOSPITAL OF BOSCOBEL
Doing business as
Gundersen Boscobel Area Hospital and Clinics
Practice address
205 Parker St
Boscobel, WI 53805-1642
Phone
(608) 375-4112
Fax
(608) 375-5463
NPI assigned
Mar 7, 2006
Last updated
Aug 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Authorized official

Name
Jennifer Boigenzahn
Title
Finance Administrator
Phone
(608) 375-6228

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X NU Primary

Addresses

Primary practice location

205 Parker St
Boscobel, WI 53805-1642

Mailing address

205 Parker St
Boscobel, WI 53805-1642
Phone (608) 375-4112

Other identifiers 1

IdentifierTypeStateIssuer
11015210MedicaidWI

Other names 1

  • Gundersen Boscobel Area Hospital and Clinics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040115000725 WI Part B Supplier - Clinic/Group Practice 8325957673 Receives reassigned benefits from 316 practitioners
6 other NPIs on this enrollment
Practice locations: Viroqua, WI; Whitehall, WI; Prairie Du Chien, WI; Onalaska, WI; Muscoda, WI; Milwaukee, WI; Mequon, WI; La Crosse, WI…
O20101008000082 WI Part A Provider - Critical Access Hospital 8325957673 Receives reassigned benefits from 82 practitioners
Practice locations: Boscobel, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1760459846. Details of each certification follow.

Hospital certification: CCN 521344

Legal name
MEMORIAL HOSPITAL OF BOSCOBEL
Doing business as
GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 1, 2004
Last certification
Dec 3, 2025
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
May 1, 1952 in WI
Enrollment address
205 Parker St
Boscobel, WI 53805-1642
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Gundersen Boscobel Area Hospital and ClinicsCCN 521344 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gary Boughton Individual Corporate Director Feb 1, 2022
Gerald Berge Individual Corporate DirectorBoard Member Chairman of the Boa Jan 25, 2005
Jennifer Boigenzahn Individual Corporate DirectorChief Financial Officer Sep 16, 2020
Andrew W Nahas Individual Corporate Director Dec 17, 2019
Cynde Larsen Individual Corporate DirectorBoard Member Feb 1, 2016
Krister Mattson Individual Corporate DirectorBoard Member Aug 25, 2025
Alan Eber Individual Corporate Director Feb 1, 2022
Bellin Gundersen Health System Inc Organization, La Crosse, WI Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Nov 30, 2022
Operational/Managerial Control Nov 30, 2022
Emily McCormick Individual Corporate DirectorBoard Member Jun 1, 2023
Gundersen Lutheran Health System Inc Organization, La Crosse, WI Non-profit 5% Or Greater Direct Ownership Interest Oct 1, 2013 100%
Operational/Managerial Control Oct 1, 2013 100%
Kelsey Cordova Individual Corporate DirectorBoard Member Jan 1, 2026
Tim Wilson Individual Corporate DirectorBoard Member Jan 1, 2025
Theresa Braudt Individual W-2 Managing EmployeeDirector of Nursing Sep 1, 2012

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 49

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 49

Practitioners & affiliated clinicians

Practitioners 329

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 329

Affiliated clinicians 111

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 111

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628121600000",
    "number": "1760459846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 PARKER ST",
            "city": "BOSCOBEL",
            "state": "WI",
            "postal_code": "538051642",
            "telephone_number": "608-375-4112",
            "fax_number": "608-375-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 PARKER ST",
            "city": "BOSCOBEL",
            "state": "WI",
            "postal_code": "538051642",
            "telephone_number": "608-375-4112",
            "fax_number": "608-375-5463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HOSPITAL OF BOSCOBEL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-07",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A",
        "authorized_official_last_name": "BOIGENZAHN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "FINANCE ADMINISTRATOR",
        "authorized_official_telephone_number": "608-375-6228"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11015210",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gundersen Boscobel Area Hospital and Clinics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gundersen Boscobel Area Hospital and Clinics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boscobel, WI

Sources for this page

Verify at the official NPI Registry.