Susan G Maclellan-Tobert, MD

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

37282 Issued in WI

Practice address

1836 South Ave
La Crosse, WI 54601-5429

Phone

(608) 782-7300

NPI assigned

May 24, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smaclellantobert9716@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 NPD
• Memorial Hospital of Boscobel

  • Critical Access Hospital
  • Boscobel, WI
  • NPI 1760459846
  Medicare reassignment NPD
• Moundview Memorial Hospital & Clinics, Inc

  • Critical Access Hospital
  • Friendship, WI
  • NPI 1710939533
  Medicare reassignment NPD
• St. Joseph'S Health Services, Inc.

  • Clinic/Center
  • Hillsboro, WI
  • NPI 1104031798
  Medicare reassignment NPD
• Tomah Memorial Hospital Inc

  • Critical Access Hospital
  • Tomah, WI
  • NPI 1992970453
  Medicare reassignment NPD
• Tri-County Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Whitehall, WI
  • NPI 1417201864
  Medicare reassignment NPD
• Vernon Memorial Healthcare, Inc.

  • Critical Access Hospital
  • Viroqua, WI
  • NPI 1497750921
  Medicare reassignment NPD
• Palmer Lutheran Health Center, Inc.

  • Critical Access Hospital
  • West Union, IA
  • NPI 1891744108

  WI

  Medicare reassignment NPD
• Gundersen Clinic LTD

  • Clinic/Center
  • La Crosse, WI
  • NPI 1851343115
  Medicare reassignment
• Memorial Hospital of Boscobel

  • Medicare Defined Swing Bed Hospital Unit
  • Boscobel, WI
  • NPI 1497712624
  NPD
• Moundview Memorial Hospital & Clinics, Inc.

  • Clinic Pharmacy
  • Friendship, WI
  • NPI 1669056693
  NPD
• Moundview Memorial Hospital & Clinics, Inc.

  • Rural Health Clinic/Center
  • Westfield, WI
  • NPI 1861829194
  NPD

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1952304834",
    "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": "800 West Ave S",
            "address_purpose": "LOCATION",
            "city": "LA Crosse",
            "state": "WI",
            "postal_code": "546018806",
            "country_code": "US",
            "telephone_number": "608-785-0940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACLELLAN-TOBERT",
        "first_name": "SUSAN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-24",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "WI",
            "license": "37282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34278900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katrina B Macfarland, PTA
• Shelby Danielle Mach, LCSW
• Betty Ann Macha, RN, BSN, MS
• Mariah Lynn Mack, MD
• Thomas Stuart Mackenzie, DDS
• Jill M Mader, PHARM. D.
• Michael H Mader, MD
• Melani Beth Madero, OCCUPATIONAL THERPY
• Micah Madsen
• Rhonda J Madsen, MSW

• Pediatric Cardiology Physician in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Pediatric Cardiology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.