NPIMap

Individual provider Active NPI

Benjamin S Mixis

  • Neurology Physician
  • La Crosse, WI
National Provider Identifier
1932635935
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
69972 Issued in WI
Practice address
1836 South Ave
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
May 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 69972 WI Primary

Addresses

Primary practice location

1836 South Ave
La Crosse, WI 54601-5429

Mailing address

1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300

Other practice location 1

600 Highland Ave
Madison, WI 53792-0001
Phone (608) 232-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, MN, WI3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20220810001769 IA Practitioner - Neurology 3173893393 Reassigns benefits to 1 organization
I20220818001727 MN Practitioner - Neurology 3173893393 Reassigns benefits to 2 organizations
I20220818003783 WI Practitioner - Neurology 3173893393 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Wisconsin School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gundersen Lutheran Medical Center IncGroup PAC ID 2163331414, shared by 16 NPIs, 888 clinicians

Practice addresses (Care Compare)

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

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

Hospital & facility affiliations

  • Gundersen Lutheran Medical Center Hospital, La Crosse, WI, CCN 520087
  • Tomah Memorial Hospital Hospital, Tomah, WI, CCN 521320
  • St Elizabeth Medical Center Hospital, Wabasha, MN, CCN 241335
  • Crossing Rivers Health Medical Center Hospital, Prairie Du Chien, WI, CCN 521330
  • Gundersen Boscobel Area Hospital and Clinics Hospital, Boscobel, WI, CCN 521344

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Medical Center Inc CurrentSince Jul 25, 2022 Accepting new patients
Gundersen Lutheran Express Care, Inc CurrentSince Jul 25, 2022 Accepting new patients
Gundersen Clinic, LTD. CurrentSince Aug 4, 2022 Accepting new patients
Gundersen Clinic LTD CurrentSince Jul 25, 2022 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Jul 25, 2022 Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Gundersen Clinic LTD CurrentSince Jul 25, 2022 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Jul 25, 2022 Accepting new patients

Locations

1830 State Highway 9
Decorah, IA 52101
Phone (563) 382-2639

123 5th Ave SE
Spring Grove, MN 55974
Phone (507) 498-3302

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

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

711 W Adams St
Blk River Fls, WI 54615
Phone (715) 284-1302

402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331

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

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

1600 Main St
Onalaska, WI 54650
Phone (608) 783-4681

610 E Taylor St
Prairie du Chien, WI 53821
Phone (608) 326-6466

Interoperability endpoints

  • Direct secure messaging: bmixis552017@direct.emplifyhealth.org

Organizations & group practices 8

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.

Hospital & facility affiliations 11

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1932635935",
    "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": [
        {
            "address_1": "600 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537920001",
            "country_code": "US",
            "telephone_number": "608-232-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIXIS",
        "first_name": "BENJAMIN",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "69972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.