NPIMap

Individual provider Active NPI

Cody William Teslow, PA

  • Medical Physician Assistant
  • La Crosse, WI
National Provider Identifier
1770870933
Registry record updated Dec 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3066 Issued in WI
Practice address
1836 South Ave
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
Jul 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 002224 IA
Medical Physician Assistant 363AM0700X 11917 MN
Medical Physician Assistant 363AM0700X 3066 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 IA, WI, 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
I20110912000543 IA Practitioner - Physician Assistant 7214108844 Reassigns benefits to 1 organization
I20130403000290 WI Practitioner - Physician Assistant 7214108844 Reassigns benefits to 4 organizations
I20160304000153 MN Practitioner - Physician Assistant 7214108844 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3066WIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-County Memorial Hospital, Inc. CurrentSince Nov 6, 2019 Accepting new patients
Gundersen Lutheran Express Care, Inc CurrentSince Feb 11, 2013 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince May 1, 2024 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Apr 8, 2019 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince May 1, 2024 Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Apr 8, 2019 Accepting new patients
Fairview Health Services CurrentSince Jan 23, 2016 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Nov 3, 2019 Accepting new patients
Gundersen Clinic LTD CurrentSince Dec 27, 2017 Accepting new patients
Gundersen Clinic, LTD. CurrentSince Jul 20, 2015 Accepting new patients
Fairview Health Services CurrentSince Jan 23, 2016 Accepting new patients
Tri-County Memorial Hospital, Inc. CurrentSince Nov 6, 2019 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc Past Accepting new patients
Gundersen Clinic LTD Past Accepting new patients
Gundersen Clinic, LTD. Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

123 5th Ave SE
Spring Grove, MN 55974
Phone (507) 498-3302

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

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

601 S Center Ave
Merrill, WI 54452
Phone (715) 536-5511

3111 Gundersen Dr
Onalaska, WI 54650
Phone (608) 775-8100

1600 Main St
Onalaska, WI 54650
Phone (608) 783-4681

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

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

Interoperability endpoints

  • Direct secure messaging: cteslow61292@direct.emplifyhealth.org

Organizations & group practices 33

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.

View all 33

Hospital & facility affiliations 9

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

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Iowa, RJ & L Carver College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gundersen Clinic LTD 422 clinicians
Tri-County Memorial Hospital Inc 75 clinicians
Gundersen Lutheran Medical Center Inc 888 clinicians

Practice addresses (Care Compare)

1111 W Wisconsin St
Sparta, WI 54656-2233
Phone (608) 269-6731

18601 Lincoln St
Whitehall, WI 54773-8605
Phone (715) 538-4361

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

402 A W Lake St
Friendship, WI 53934-9699
Phone (608) 339-8471

402 W Lake St
Friendship, WI 53934-9699
Phone (608) 339-3331

Hospital & facility affiliations

  • Gundersen Lutheran Medical Center Hospital, La Crosse, WI, CCN 520087
  • Vernon Memorial Hospital Hospital, Viroqua, WI, CCN 521348
  • Gundersen St Josephs Hospital and Clinics Hospital, Hillsboro, WI, CCN 521304

NPI Registry JSON

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513123200000",
    "number": "1770870933",
    "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": "TESLOW",
        "first_name": "CODY",
        "middle_name": "WILLIAM",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-07",
        "last_updated": "2017-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "002224",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "11917",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "3066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.