Individual provider Active NPI

Gerald Dennis Fushianes, PA-C

  • Physician Assistant
  • Tomah, WI
National Provider Identifier
1881727113
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1811-023 Issued in WI
Practice address
501 Gopher Dr
Tomah, WI 54660-4513
Phone
(608) 371-2181
NPI assigned
Mar 14, 2007
Last updated
Jun 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1811-023 WI Primary
Medical Physician Assistant 363AM0700X 002256 IA
Medical Physician Assistant 363AM0700X AMD-312 HI
Medical Physician Assistant 363AM0700X 1351 NE
Medical Physician Assistant 363AM0700X PA19722 CA
Medical Physician Assistant 363AM0700X 1811-023 WI
Medical Physician Assistant 363AM0700X 5601002730 MI
Medical Physician Assistant 363AM0700X 10386 MN

Addresses

Primary practice location

501 Gopher Dr
Tomah, WI 54660-4513

Mailing address

501 Gopher Dr
Tomah, WI 54660-4513
Phone (608) 371-2181

Other practice location 1

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

Other practice location 2

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

Other practice location 3

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

Other practice location 4

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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jfushianes10703@direct.monroeclinic.org Direct Tomah Memorial Hospital Inc

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
I20050302000732 WI Practitioner - Physician Assistant 9436102340 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tomah Memorial Hospital IncGroup PAC ID 6901897016, 54 clinicians

Practice addresses (Care Compare)

501 Gopher Dr
Tomah, WI 54660-4513
Phone (608) 372-2181

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA19722CAMDMedical Physician Assistant
AMD-312HIMDMedical Physician Assistant
5601002730MIMDMedical Physician Assistant
1811-023WIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Black River Health Inc CurrentSince Oct 27, 2020 Accepting new patients
Tri-County Memorial Hospital Inc CurrentSince Feb 16, 2019 Accepting new patients
Tri-County Memorial Hospital, Inc. CurrentSince Feb 16, 2019 Accepting new patients
Tomah Memorial Hospital Inc CurrentSince Jan 1, 2014 Accepting new patients
Black River Health Inc CurrentSince Oct 27, 2020 Accepting new patients
Tomah Memorial Hospital Inc CurrentSince Jan 1, 2014 Accepting new patients
Family Doctors Past Accepting new patients

Locations

711 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-3604

501 Gopher Dr
Tomah, WI 54660
Phone (608) 371-2181

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

Interoperability endpoints

  • Direct secure messaging: gfushianes55356@direct.gundersenhealth.org
  • Direct secure messaging: gfushianes750891@direct.emplifyhealth.org
  • Direct secure messaging: jfushianes10703@direct.monroeclinic.org

Organizations & group practices 10

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 1

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1881727113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 GOPHER DR",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546604513",
            "telephone_number": "608-371-2181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 GOPHER DR",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546604513",
            "telephone_number": "608-371-2181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 West Ave S",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "54601",
            "country_code": "US",
            "telephone_number": "608-785-0940",
            "fax_number": "608-374-0355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18601 Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Whitehall",
            "state": "WI",
            "postal_code": "54773",
            "country_code": "US",
            "telephone_number": "715-538-4361",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18601 Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Whitehall",
            "state": "WI",
            "postal_code": "54773",
            "country_code": "US",
            "telephone_number": "715-538-4361",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18601 Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Whitehall",
            "state": "WI",
            "postal_code": "54773",
            "country_code": "US",
            "telephone_number": "715-538-4361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUSHIANES",
        "first_name": "GERALD",
        "middle_name": "DENNIS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1811-023",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "002256",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "HI",
            "license": "AMD-312",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "1351",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA19722",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "1811-023",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601002730",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "10386",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfushianes10703@direct.monroeclinic.org",
            "affiliation": "Y",
            "affiliationName": "Tomah Memorial Hospital Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jfushianes10703@direct.monroeclinic.org",
            "address_1": "501 Gopher Dr",
            "city": "Tomah",
            "state": "WI",
            "country_code": "US",
            "postal_code": "546604513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tomah, WI

Sources for this page

Verify at the official NPI Registry.