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JORDAN SHORTREED
NPI 1417650607
Internal Medicine in La Crosse, WI

Active since March 24, 2023PECOS Enrolled
1836 SOUTH AVE, LA CROSSE, WI 54601(608) 782-7300 Get Directions Write a Review

NPPES record last updated: August 25, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 25, 2026, Mar 24, 2023 (2 updates tracked since 2023).

About Jordan Shortreed NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JORDAN SHORTREED (NPI 1417650607) is an individual internal medicine provider in La Crosse, Wisconsin, licensed in Wisconsin (84703-20) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1417650607
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameJORDAN SHORTREED
Location Address1836 SOUTH AVELa Crosse, WI 54601-5429
Mailing Address1836 South AveLa Crosse, WI 54601-5429 · (608) 782-7300
Phone(608) 782-7300
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateMarch 24, 2023
Last NPPES UpdateAugust 25, 20262 updates tracked since enumeration
NPPES CertifiedAugust 25, 2026
✔ NPI 1417650607 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in WI · 84703-20
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1836 SOUTH AVE, La Crosse, WI 54601
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jordan Shortreed is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7911368576
PECOS Enrollment IDI20260903003820
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jordan Shortreed reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Gundersen Lutheran Medical Center, Inc
Same address
Clinic/Center
1836 SOUTH AVE
La Crosse, WI 54601
  • Reassigned Medicare billing, Wisconsin enrollment
  • 1,457 clinicians in this Medicare group
NPI 1689918377 (608) 782-7300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54601 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JEFFREY BRIAN TROHKIMOINEN M.D.
Anesthesiology
1836 SOUTH AVE, GUNDERSEN CLINIC, LTD.
LA CROSSE, WI 54601
La Crosse County (608) 775-2031
JESSICA E THESING CRNA
Nurse Anesthetist, Certified Registered
1836 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (608) 782-7300
DR. MICHAEL DAVID SMITH PSY.D.
Psychologist
1836 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (608) 782-7300
JESSICA MAE RASMUSSEN
Surgery
1836 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (608) 782-7300
JULIE SONSALLA NP
Nurse Practitioner (Adult Health)
1836 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (608) 782-7300
LAURA KLINGBEIL
Orthopaedic Surgery
1836 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (608) 782-7300
SUSAN CAROL SORRENTINO RN
Registered Nurse (Addiction (Substance Use Disorder))
1836 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (608) 782-7300
NAOMI MUTHONI RUIRU NP
Nurse Practitioner (Family)
1836 SOUTH AVE
LA CROSSE, WI 54601
La Crosse County (608) 782-7300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jordan Shortreed's NPI number?

The NPI number for Jordan Shortreed is 1417650607. It was assigned to this individual provider in the NPPES registry on March 24, 2023.

Where is Jordan Shortreed located?

Jordan Shortreed practices at 1836 South Ave, La Crosse, WI 54601. The listed phone number is (608) 782-7300.

What is Jordan Shortreed's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jordan Shortreed enrolled in Medicare?

Yes. Jordan Shortreed is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jordan Shortreed's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jordan Shortreed reassigns Medicare benefits to Gundersen Lutheran Medical Center, Inc (La Crosse, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jordan Shortreed's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jordan Shortreed was last updated on August 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.