Active NPI
Baycare Clinic LLP
- Durable Medical Equipment & Medical Supplies
- Manitowoc, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- BAYCARE CLINIC LLP
- Practice address
- 930 Maritime Dr
Manitowoc, WI 54220-2961 - Phone
- (920) 682-9121
- Fax
- (920) 682-7188
- NPI assigned
- Jan 13, 2012
- Last updated
- Aug 27, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Taylor Konkle
- Title
- Payor Enrollment
- Phone
- (920) 301-1327
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | |||
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
930 Maritime Dr
Manitowoc, WI 54220-2961
Mailing address
PO Box 28900
Green Bay, WI 54324-0900
Phone (920) 490-9046
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241221000043 | WI | DME Supplier - Physician - Maxillofacial Surgery | 4385554328 | Practice locations: Manitowoc, WI |
Other NPIs with the same Medicare PAC ID 7
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Durable Medical Equipment & Medical Supplies
- Green Bay, WI
- NPI 1851336242
4385554328
-
- Durable Medical Equipment & Medical Supplies
- Manitowoc, WI
- NPI 1376129833
4385554328
-
- Durable Medical Equipment & Medical Supplies
- Kaukauna, WI
- NPI 1437789450
4385554328
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D2090134 | Baycare Clinic, LLP | Certificate of waiver | Jan 14, 2027 |
National Provider Directory
National Provider DirectoryLocations
1711 S Stephenson Ave
Ste 230
Iron Mountain, MI 49801
Phone (877) 229-2273
4648 W Spencer St
Appleton, WI 54914
Phone (920) 731-7557
2253 W Mason St
#100
Green Bay, WI 54303
Phone (920) 327-7000
2253 W Mason St
Ste 100
Green Bay, WI 54303
Phone (920) 327-7000
2605 Development Dr
Green Bay, WI 54311
Phone (920) 288-8240
2845 Greenbrier Rd
Fl 2
Green Bay, WI 54311
Phone (920) 288-4700
2845 Greenbrier Rd
Ste 220
Green Bay, WI 54311
Phone (920) 288-8230
1500 Arbor Way
Ste 300
Kaukauna, WI 54130
Phone (920) 327-7200
1111 Bayshore Dr
Manitowoc, WI 54220
Phone (920) 682-6376
930 Maritime Dr
Manitowoc, WI 54220
Phone (920) 682-9121
1400 University Dr
Marinette, WI 54143
Phone (715) 732-4181
3003 University Dr
Ste 304
Marinette, WI 54143
Phone (715) 732-8200
3117 Shore Dr
#102
Marinette, WI 54143
Phone (715) 732-8200
3130 Shore Dr
Ste 109
Marinette, WI 54143
Phone (715) 735-9494
10624 N Port Washington Rd
Mequon, WI 53092
Phone (920) 497-0003
1136 Westowne Dr
Neenah, WI 54956
Phone (920) 456-2030
480 N Koeller St
Oshkosh, WI 54902
Phone (920) 233-8739
630 Riverfront Dr
Sheboygan, WI 53081
Phone (920) 682-6376
242 Michigan St
Ste 301
Sturgeon Bay, WI 54235
Phone (866) 726-8200
30 N 18th Ave
Ste 6
Sturgeon Bay, WI 54235
Phone (920) 743-2001
636 N 12th Ave
Sturgeon Bay, WI 54235
Phone (920) 743-2001
5300 Memorial Dr
Ste 303
Two Rivers, WI 54241
Phone (920) 793-6550
Practitioners & affiliated clinicians
Practitioners 365
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Certified Registered Nurse Anesthetist
- Green Bay, WI
- NPI 1184981532
-
- Plastic and Reconstructive Surgery Physician
- Green Bay, WI
- NPI 1164711172
-
- Emergency Medicine Physician
- Green Bay, WI
- NPI 1639497621
-
- Certified Registered Nurse Anesthetist
- Green Bay, WI
- NPI 1417601725
-
- Nurse Practitioner
- Green Bay, WI
- NPI 1609616341
-
- Ophthalmology Physician
- Green Bay, WI
- NPI 1720098288
-
- Audiologist
- Green Bay, WI
- NPI 1487632329
-
- Emergency Medicine Physician
- Summit, WI
- NPI 1649224767
-
- Physician Assistant
- Green Bay, WI
- NPI 1073999397
-
- Certified Registered Nurse Anesthetist
- Green Bay, WI
- NPI 1760494512
-
- Audiologist
- Green Bay, WI
- NPI 1568461481
-
- Orthopaedic Surgery Physician
- Green Bay, WI
- NPI 1649615329
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326412800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1787788800000",
"number": "1134490758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 28900",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543240900",
"telephone_number": "920-490-9046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "930 MARITIME DR",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542202961",
"telephone_number": "920-682-9121",
"fax_number": "920-682-7188"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BAYCARE CLINIC LLP",
"organizational_subpart": "NO",
"enumeration_date": "2012-01-13",
"last_updated": "2026-08-27",
"certification_date": "2026-08-27",
"status": "A",
"authorized_official_last_name": "KONKLE",
"authorized_official_first_name": "TAYLOR",
"authorized_official_title_or_position": "PAYOR ENROLLMENT",
"authorized_official_telephone_number": "920-301-1327"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Manitowoc, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.