Individual provider Active NPI

Bradley T Bodner, PA-C

  • Surgical Physician Assistant
  • Wausau, WI
National Provider Identifier
1093767808
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
1312-023 Issued in WI
Practice address
2800 Westhill Dr
Suite 200
Wausau, WI 54401-3771
Phone
(715) 843-1000
NPI assigned
May 17, 2006
Last updated
Dec 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 1312-023 WI Primary

Addresses

Primary practice location

2800 Westhill Dr
Suite 200
Wausau, WI 54401-3771

Mailing address

2800 Westhill Drive
Suite 200
Wausau, WI 54402-3770
Phone (715) 843-1000

Other practice location 1

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

Other identifiers 1

IdentifierTypeStateIssuer
41923000MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060524000150 WI Practitioner - Physician Assistant 4880605294 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCHS Hospitals IncGroup PAC ID 5698071173, 1,195 clinicians

Practice addresses (Care Compare)

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

2727 Plaza Dr
Wausau, WI 54401-4129
Phone (715) 847-3000

3400 Ministry Pkwy
Weston, WI 54476-5220
Phone (715) 393-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.58 of 100Reported as group
Quality
55.5
Promoting interoperability
100
Improvement activities
40
Cost
71.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1312WIMDAddiction (Substance Use Disorder) Counselor
1312-023WIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Inc CurrentSince Apr 2, 2023 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Oct 23, 2017 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Apr 2, 2023 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Flambeau Hospital Inc CurrentSince Apr 2, 2023 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Apr 2, 2023 Accepting new patients
Memorial Hospital Inc CurrentSince Apr 2, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince Apr 12, 2021 Accepting new patients
MCHS Hospitals Inc CurrentSince Apr 12, 2021 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Apr 2, 2023 Accepting new patients
Flambeau Hospital Inc CurrentSince Apr 2, 2023 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Oct 23, 2017 Accepting new patients
Marshfield Clinic Inc CurrentSince Apr 12, 2021 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Apr 2, 2023 Accepting new patients
Urology Specialists of Wisconsin SC Past Accepting new patients
Bone & Joint Clinic S.C. Surgical Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

225000 Hummingbird Rd
Ste 100
Rib Mountain, WI 54401
Phone (715) 359-3442

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

3200 Westhill Dr
Ste 102
Wausau, WI 54401
Phone (715) 847-2020

4005 Community Center Dr
Weston, WI 54476
Phone (715) 241-5400

Interoperability endpoints

  • Direct secure messaging: bradley.bodner@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 17

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 17

Hospital & facility affiliations 1

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1093767808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 WESTHILL DRIVE",
            "address_2": "SUITE 200",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544023770",
            "telephone_number": "715-843-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 WESTHILL DR",
            "address_2": "SUITE 200",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013771",
            "telephone_number": "715-843-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 N Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Marshfield",
            "state": "WI",
            "postal_code": "544495703",
            "country_code": "US",
            "telephone_number": "715-387-5511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BODNER",
        "first_name": "BRADLEY",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "1312-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41923000",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1000 N Oak Ave",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.