Eau Claire Gi Associates SC

Primary specialty

SpecialistTaxonomy code 174400000X

License

37801-020 Issued in WI

Legal business name

EAU CLAIRE GI ASSOCIATES SC

Practice address

4109 Oakwood Hills Parkway
Eau Claire, WI 54701-8888

Phone

(715) 552-7303

Fax

(715) 552-7355

NPI assigned

Nov 13, 2006

Last updated

May 21, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amy Fogeltanz

Title

Practice Manager

Phone

(715) 552-7303

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Molly Elizabeth Boyle-Engedal, APNP

  • Family Nurse Practitioner
  • Eau Claire, WI
  • NPI 1730676537
  Medicare reassignment Care Compare group NPD
• Camellia Dalai, MD

  • Gastroenterology Physician
  • Eau Claire, WI
  • NPI 1801384250
  Medicare reassignment Care Compare group NPD
• Ursula Rae Lindblad, NP

  • Nurse Practitioner
  • Eau Claire, WI
  • NPI 1780989715
  Medicare reassignment Care Compare group NPD
• Tabetha Christy Patrow, MNS, NP-C

  • Nurse Practitioner
  • Eau Claire, WI
  • NPI 1881184091
  Medicare reassignment Care Compare group NPD
• Thomas P Peller, M.D.

  • Gastroenterology Physician
  • Eau Claire, WI
  • NPI 1497715726
  Medicare reassignment Care Compare group NPD
• Jon Warren Potter, D.O.

  • Gastroenterology Physician
  • Eau Claire, WI
  • NPI 1093785180
  Medicare reassignment Care Compare group NPD
• Paul James Ruh, MD

  • Gastroenterology Physician
  • Eau Claire, WI
  • NPI 1578670832
  Medicare reassignment Care Compare group NPD
• Sarah Crosbie

  • Family Nurse Practitioner
  • Eau Claire, WI
  • NPI 1073433710
  NPD
• Jennifer J Wundrow, RN

  • Registered Nurse
  • Eau Claire, WI
  • NPI 1841117512
  NPD (past)

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747785600000",
    "number": "1912078718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4109 OAKWOOD HILLS PARKWAY",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547018888",
            "telephone_number": "715-552-7303",
            "fax_number": "715-552-7355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4109 OAKWOOD HILLS PARKWAY",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547018888",
            "telephone_number": "715-552-7303",
            "fax_number": "715-552-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAU CLAIRE GI ASSOCIATES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A",
        "authorized_official_last_name": "FOGELTANZ",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "715-552-7303"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WI",
            "license": "37801-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID NUMBER",
            "identifier": "=========",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH7600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eau Claire County Department of Human Services
• Eau Claire County Dept of Human Services
• Eau Claire County Dept. of Human Services
• Eau Claire County Dept. of Human Services
• Eau Claire Family Dental
• Eau Claire Heart Institute
• Eau Claire Home Care LLC
• Eau Claire Medical Clinic, S.C.
• Eau Claire Medical Clinic, S.C.
• Eau Claire Metro Treatment Center

• Specialist in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Specialist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.