Allicen Marie Waxlax, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

81051 Issued in WI

Practice address

1836 South Ave
La Crosse, WI 54601-5429

Phone

(608) 782-7300

NPI assigned

Apr 5, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Allicen Marie Waxlax Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Minnesota Medical School, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gundersen Lutheran Medical Center IncGroup PAC ID 2163331414, 888 clinicians

Tri-County Memorial Hospital IncGroup PAC ID 4587642418, 75 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gundersen Tri-County Hospital & Clinics Hospital, Whitehall, WI, CCN 521316

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: awaxlax521941@direct.emplifyhealth.org

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.

• Gundersen Lutheran Medical Center Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1225873458
  Medicare reassignment Care Compare group NPD
• Tri-County Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Whitehall, WI
  • NPI 1417201864
  Medicare reassignment Care Compare group NPD
• Tri-County Memorial Hospital, Inc.

  • Critical Access Hospital
  • Whitehall, WI
  • NPI 1124063573
  Medicare reassignment NPD (past)
• Gundersen Lutheran Medical Center Inc

  • Clinic/Center
  • Milwaukee, WI
  • NPI 1871222117
  NPD
• Gundersen Lutheran Medical Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Onalaska, WI
  • NPI 1871837567
  NPD
• Tri-County Memorial Hospital, Inc.

  • Clinic/Center
  • Independence, WI
  • NPI 1073335642
  NPD
• Gundersen Lutheran Medical Center Inc

  • General Acute Care Hospital
  • La Crosse, WI
  • NPI 1376593442
  NPD (past)

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

• Tri-County Memorial Hospital, Inc.

  • Critical Access Hospital
  • Whitehall, WI
  • NPI 1124063573
  Care Compare affiliation
• Tri-County Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Whitehall, WI
  • NPI 1417201864

  Hospital

  Care Compare affiliation
• Tri-County Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Blair, WI
  • NPI 1659625192

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1841879244",
    "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": "WAXLAX",
        "first_name": "ALLICEN",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "81051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLICEN",
            "last_name": "WAXLAX",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Douglas W Watkins, PT
• Kathleen Mary Watring
• Mary B Watts, MS
• Kasmier Lee Wawrzaszek, PA
• Robert E Wax, MD
• Shawn Wayne
• Alyssa Wciorka
• Joshua Douglas Weaver
• Luke Weaver, DO
• Alaina Joan Webb

• Family Medicine Physician in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.