NPIMap

Organization Active NPI

Aurora Bay Area Medical Group, LLC

Doing business as Bay Area Surgical Consultants

  • Durable Medical Equipment & Medical Supplies
  • Marinette, WI
National Provider Identifier
1174981047
Registry record updated Feb 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
AURORA BAY AREA MEDICAL GROUP, LLC
Doing business as
Bay Area Surgical Consultants
Practice address
3130 Shore Dr
Suite 30
Marinette, WI 54143-4291
Phone
(715) 735-8056
Fax
(715) 735-8057
NPI assigned
Feb 5, 2016
Last updated
Feb 5, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2016

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

Authorized official

Name
Timothy W Lineberry, M.D.
Title
Board Chairman
Phone
(920) 288-8612

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

3130 Shore Dr
Suite 30
Marinette, WI 54143-4291

Mailing address

3100 Shore Dr
Marinette, WI 54143-4242

Other identifiers 1

IdentifierTypeStateIssuer
1295122729MedicaidWI

Other names 1

  • Bay Area Surgical Consultants Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Aurora Bay Area Medical Group LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3130 Shore Dr
Ste 30
Marinette, WI 54143
Phone (715) 735-8056

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1454630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454630400000",
    "number": "1174981047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SHORE DR",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434242",
            "fax_number": "715-735-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 SHORE DR",
            "address_2": "SUITE 30",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434291",
            "telephone_number": "715-735-8056",
            "fax_number": "715-735-8057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AURORA BAY AREA MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-05",
        "last_updated": "2016-02-05",
        "status": "A",
        "authorized_official_last_name": "LINEBERRY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "BOARD CHAIRMAN",
        "authorized_official_telephone_number": "920-288-8612",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295122729",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bay Area Surgical Consultants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marinette, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.