Individual provider Active NPI

Samantha Stark, MD

  • Emergency Medicine Physician
  • La Crosse, WI
National Provider Identifier
1962866343
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
73379-20 Issued in WI
Practice address
1836 South Ave
La Crosse, WI 54601-5429
Phone
(608) 782-7300
NPI assigned
Apr 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 125068358 IL
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 73379-20 WI
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 73379-20 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

Uw Hospitals & Clinics 600 Highland Ave
Madison, WI 53792-3468
Phone (608) 263-6400

Other names 1

  • Samantha Knopp Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201230000188 WI Practitioner - Emergency Medicine 2567744857 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Wisconsin School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

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

3111 Gundersen Dr
Onalaska, WI 54650-8447
Phone (608) 782-7300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125068358ILMDEmergency Medicine Physician
73379-20WIMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Medical Center, Inc Hospice and Palliative Medicine CurrentSince Aug 9, 2021 Accepting new patients
Mercy Health System Corporation CurrentSince Oct 30, 2020 Accepting new patients
St. Joseph'S Health Services, Inc. Hospice and Palliative Medicine CurrentSince Aug 19, 2021 Accepting new patients
Tri-County Memorial Hospital, Inc. Hospice and Palliative Medicine Current Accepting new patients
Gundersen Clinic LTD CurrentSince Aug 9, 2021 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc. CurrentSince Aug 17, 2021 Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Tomah Memorial Hospital Inc Emergency Medicine CurrentSince Oct 1, 2021 Accepting new patients
Tomah Memorial Hospital Inc CurrentSince Dec 1, 2025 Accepting new patients
Mercy Health System Corporation Current Accepting new patients
St. Joseph'S Health Services, Inc. Current Accepting new patients
Memorial Hospital of Boscobel CurrentSince Aug 9, 2021 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Aug 9, 2021 Accepting new patients
Moundview Memorial Hospital & Clinics, Inc. CurrentSince Aug 17, 2021 Accepting new patients
Memorial Hospital of Boscobel CurrentSince Aug 9, 2021 Accepting new patients
Mercy Health System Corporation CurrentSince Oct 30, 2020 Accepting new patients
Tomah Memorial Hospital Inc CurrentSince Oct 1, 2021 Accepting new patients
Tri-County Memorial Hospital, Inc. Hospice and Palliative Medicine CurrentSince Aug 24, 2021 Accepting new patients
Gundersen Lutheran Express Care, Inc CurrentSince Aug 9, 2021 Accepting new patients
Tri-County Memorial Hospital, Inc. CurrentSince Aug 24, 2021 Accepting new patients
Gundersen Clinic LTD Current Accepting new patients
Moundview Memorial Hospital & Clinics, Inc Hospice and Palliative Medicine Current Accepting new patients
St. Joseph'S Health Services, Inc. Hospice and Palliative Medicine Past Accepting new patients
Memorial Hospital of Boscobel Hospice and Palliative Medicine Past Accepting new patients
Gundersen Lutheran Medical Center Inc Past Accepting new patients
Tri-County Memorial Hospital, Inc. Past Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

205 Parker St
Boscobel, WI 53805
Phone (608) 375-4112

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

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

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

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

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

3111 Gundersen Dr
Onalaska, WI 54650
Phone (608) 775-8100

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

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

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

Interoperability endpoints

  • Direct secure messaging: sstark544563@direct.emplifyhealth.org

Organizations & group practices 26

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.

View all 26

Hospital & facility affiliations 8

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": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1962866343",
    "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": "Uw Hospitals & Clinics 600 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537923468",
            "country_code": "US",
            "telephone_number": "608-263-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STARK",
        "first_name": "SAMANTHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-11",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125068358",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "WI",
            "license": "73379-20",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "73379-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "KNOPP",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.