Individual provider Active NPI

Stacey A Sjoquist, PT

  • Physical Therapist
  • Onalaska, WI
National Provider Identifier
1790769404
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6355 Issued in WI
Practice address
191 Theater Rd
Onalaska, WI 54650
Phone
(608) 785-0940
NPI assigned
Dec 6, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6355 WI Primary

Addresses

Primary practice location

191 Theater Rd
Onalaska, WI 54650

Mailing address

PO Box 1510
Eau Claire, WI 54702-1510
Phone (608) 785-0940

Other practice location 1

700 West Ave S
LaCrosse, WI 54601
Phone (608) 785-0940

Other practice location 2

700 West Ave S
LaCrosse, WI 54601
Phone (608) 785-0940

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ssjoquist27303@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040930000373 WI Practitioner - Physical Therapist in Private Practice 3375512981 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6355WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Sep 1, 2004 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Sep 1, 2004 Accepting new patients

Locations

800 West Ave S
La Crosse, WI 54601
Phone (608) 372-5951

212 11th St S
La Crosse, WI 54601
Phone (608) 392-9555

700 West Ave S
La Crosse, WI 54601
Phone (608) 791-4156

191 Theater Rd
Onalaska, WI 54650
Phone (608) 392-5000

800 E Blackhawk Ave
Prairie du Chien, WI 53821
Phone (608) 326-0808

Interoperability endpoints

  • Direct secure messaging: ssjoquist27303@ehrdirect.mayoclinicmsg.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1790769404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547021510",
            "telephone_number": "608-785-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 THEATER RD",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "54650",
            "telephone_number": "608-785-0940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 West Ave S",
            "address_purpose": "LOCATION",
            "city": "LaCrosse",
            "state": "WI",
            "postal_code": "54601",
            "country_code": "US",
            "telephone_number": "608-785-0940",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 West Ave S",
            "address_purpose": "LOCATION",
            "city": "LaCrosse",
            "state": "WI",
            "postal_code": "54601",
            "country_code": "US",
            "telephone_number": "608-785-0940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SJOQUIST",
        "first_name": "STACEY",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "6355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssjoquist27303@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "191 Theater Rd",
            "city": "Onalaska",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Onalaska, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.