Individual provider Active NPI

Tara Lynn Ostromencki, DNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • La Crosse, WI
National Provider Identifier
1801550397
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11499-33 Issued in WI
Practice address
1900 South Ave
La Crosse, WI 54601-5467
Phone
(608) 782-7300
NPI assigned
Oct 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11499-33 WI Primary

Addresses

Primary practice location

1900 South Ave
La Crosse, WI 54601-5467

Mailing address

1900 South Ave
La Crosse, WI 54601-5467
Phone (608) 782-7300

Other names 1

  • Tara Lynn Candahl Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211215000923 WI Practitioner - Nurse Practitioner 5890186407 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11499-33WIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Dec 16, 2021 Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Dec 16, 2021 Accepting new patients
Haelen Mental Health, PLLC Psychiatric/Mental Health Past Accepting new patients

Locations

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

1900 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

Interoperability endpoints

  • Direct secure messaging: tcandahl61984@direct.gundersenhealth.org

Organizations & group practices 4

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": "1635465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1801550397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015467",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015467",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTROMENCKI",
        "first_name": "TARA",
        "middle_name": "LYNN",
        "credential": "DNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-29",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "11499-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "CANDAHL",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.