BLAYNE S KOZELKA PA-C
NPI 1871078667
Physician Assistant - Surgical in La Crosse, WI

Q: What is Blayne Kozelka's NPI number?

The NPI number for Blayne Kozelka is 1871078667. It was assigned to this individual provider in the NPPES registry on September 27, 2018.

Q: What is Blayne Kozelka's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Blayne Kozelka was last updated on October 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.

Active since September 27, 2018PECOS Enrolled

1836 SOUTH AVE, LA CROSSE, WI 54601(608) 782-7300 Get Directions Write a Review

NPPES record last updated: October 12, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 12, 2018, Sep 27, 2018 (2 updates tracked since 2018).

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About Blayne S Kozelka Pa-c NPPES

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

BLAYNE S KOZELKA PA-C (NPI 1871078667) is an individual surgical provider in La Crosse, Wisconsin, licensed in Wisconsin (4522) and active in the NPI registry since September 2018. He is enrolled in Medicare PECOS, is affiliated with Veterans Memorial Hospital, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1871078667

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameBLAYNE S KOZELKACredential: PA-C

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 2018

Enumeration DateSeptember 27, 2018

Last NPPES UpdateOctober 12, 20182 updates tracked since enumeration

✔ NPI 1871078667 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in WI · 4522

1836 SOUTH AVE, La Crosse, WI 54601

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, HealthPartners and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Blayne S Kozelka Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9436402633

PECOS Enrollment IDI20181105000571

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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

56 services36 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

14 services14 patients

Treatment of broken neck of thigh bone with bone implant 27245

This procedure involves repairing a fractured thigh bone by inserting a bone implant. The implant helps stabilize the bone, allowing it to heal correctly. It's performed under anesthesia and requires a hospital stay for recovery.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Veterans Memorial Hospital

Critical Access Hospitals · Waukon, IA

OwnershipGovernment - Local

CMS Certification Number161318

Location40 1st Street SEWaukon, IA 52172 · Allamakee County

Emergency services

Gundersen Lutheran Medical Center

Acute Care Hospitals · La Crosse, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520087

Location1910 South AveLa Crosse, WI 54601 · La Crosse County

Emergency services Birthing friendly

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