NPIMap

Individual provider Active NPI

Shelby Katherine Bernard, PA- C (ANTICIPATED)

  • Surgical Physician Assistant
  • La Crosse, WI
National Provider Identifier
1801557053
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
5776 Issued in WI
Practice address
1836 South Ave
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
Jan 9, 2022
Last updated
May 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 5776 WI Primary

Addresses

Primary practice location

1836 South Ave
La Crosse, WI 54601-5429

Mailing address

1513 Hyde Ave
La Crosse, WI 54601

Other practice location 1

1513 Hyde Ave
LA Crosse, WI 54601-6472
Phone (507) 421-4931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20220513001499 WI Practitioner - Physician Assistant 7618354564 Reassigns benefits to 1 organization
I20240221000614 MN Practitioner - Physician Assistant 7618354564 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

1836 S Ave
La Crosse, WI 54601-5429
Phone (608) 783-7300

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

2575 S 7TH St
Bethany Riverside
La Crosse, WI 54601-5429
Phone (608) 775-8200

3111 Gundersen Dr
Onalaska, WI 54650-8447
Phone (608) 782-7300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5776WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Elizabeths Hospital of Wabasha Inc CurrentSince Jan 10, 2025 Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Dec 7, 2023 Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince May 16, 2022 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince May 16, 2022 Accepting new patients
Saint Elizabeths Hospital of Wabasha Inc CurrentSince Jan 10, 2025 Accepting new patients
Gundersen Lutheran Medical Center, Inc. Past Accepting new patients
Saint Elizabeths Hospital of Wabasha Inc Past Accepting new patients

Locations

1200 Grant Blvd W
Wabasha, MN 55981
Phone (651) 565-4531

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

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

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

Interoperability endpoints

  • Direct secure messaging: sbernard593402@direct.emplifyhealth.org

Organizations & group practices 9

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.

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": "1641686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1801557053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 HYDE AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "54601"
        },
        {
            "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": [
        {
            "address_1": "1513 Hyde Ave",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "546016472",
            "country_code": "US",
            "telephone_number": "507-421-4931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERNARD",
        "first_name": "SHELBY",
        "middle_name": "KATHERINE",
        "credential": "PA- C (ANTICIPATED)",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-09",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "5776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.