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Baycare Clinic LLP

Organization Active NPI Durable Medical Equipment & Medical Supplies · Manitowoc, WI

NPI 1134490758 · NPPES record last updated Aug 27, 2026

Key facts

NPI
1134490758
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
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
Organization subpart
No

Authorized official

Name
Taylor Konkle
Title
Payor Enrollment
Phone
(920) 301-1327

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 332

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 332

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D2090134Baycare Clinic, LLP
930 Maritime Dr, Manitowoc, WI 54220		Certificate of waiverJan 14, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20241221000043 WI DME Supplier - Physician - Maxillofacial Surgery 4385554328 Practice locations: Manitowoc, WI

National Provider Directory

Locations

2845 Greenbrier Rd
Ste 410
Green Bay, WI 54311
Phone (920) 288-8240

1630 Commanche Ave
Green Bay, WI 54313
Phone (920) 430-4700

2845 Greenbrier Rd
Ste 310
Green Bay, WI 54311
Phone (920) 288-8300

2845 Greenbrier Rd
Ste 230
Green Bay, WI 54311
Phone (920) 288-8250

2845 Greenbrier Rd
Ste 210
Green Bay, WI 54311
Phone (920) 288-8100

2845 Greenbrier Rd
Ste 320
Green Bay, WI 54311
Phone (920) 288-8100

2253 W Mason St
#100
Green Bay, WI 54303
Phone (920) 327-7000

2581 Development Dr
Green Bay, WI 54311
Phone (920) 347-0400

1035 Kepler Dr
Green Bay, WI 54311

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

3117 Shore Dr
#102
Marinette, WI 54143
Phone (715) 732-8200

3003 University Dr
Ste 304
Marinette, WI 54143
Phone (715) 732-8200

10624 N Port Washington Rd
Mequon, WI 53092
Phone (920) 497-0003

323 E Highland Dr
#8
Oconto Falls, WI 54154
Phone (920) 846-2845

503 Doctors Ct
Oshkosh, WI 54901
Phone (414) 235-5151

920 E 5th St
Shawano, WI 54166
Phone (715) 524-2001

630 Riverfront Dr
Ste 202
Sheboygan, WI 53081
Phone (920) 457-6104

636 N 12th Ave
Sturgeon Bay, WI 54235
Phone (920) 743-2001

242 Michigan St
Ste 301
Sturgeon Bay, WI 54235
Phone (866) 726-8200

5300 Memorial Dr
Ste 303
Two Rivers, WI 54241
Phone (920) 793-6550

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)
Group: 193200000X MULTI-SPECIALTY GROUP		 1223S0112X
Durable Medical Equipment & Medical Supplies 332B00000X Yes

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

Other providers in Manitowoc, WI

All providers in Manitowoc, WI · Durable Medical Equipment & Medical Supplies in Wisconsin

Sources for this page

Verify at the official NPI Registry.