Bradley J Boettcher, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

3411 Issued in WI

Practice address

744 S Webster Ave
Green Bay, WI 54301-3505

Phone

(920) 445-7222

Fax

(920) 445-7289

NPI assigned

Mar 13, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MCHS Hospitals IncGroup PAC ID 5698071173, 1,195 clinicians

Aspirus Stevens Point Hospital and Clinics, Inc.Group PAC ID 1850358938, 136 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marshfield Medical Center - Weston Hospital, Weston, WI, CCN 520202

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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

• MCHS Hospitals Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1093221434
  Medicare reassignment Care Compare group NPD
• Aspirus Stevens Point Hospital & Clinics, Inc.

  • General Acute Care Hospital
  • Stevens Point, WI
  • NPI 1538112230
  Medicare reassignment Care Compare group
• Aspirus Merrill Hospital & Clinics, Inc.

  • Critical Access Hospital
  • Merrill, WI
  • NPI 1124084678

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.

  • Clinic/Center
  • Stevens Point, WI
  • NPI 1144991340
  Medicare reassignment NPD
• Association of Hospital Anesthesiologists SC

  • Anesthesiology Physician
  • Neenah, WI
  • NPI 1720076474
  Medicare reassignment NPD
• Marshfield Clinic Inc

  • Clinic/Center
  • Marshfield, WI
  • NPI 1952347981
  Medicare reassignment NPD
• Stevens Point Anesthesia Association, S.C.

  • Anesthesiology Physician
  • Stevens Point, WI
  • NPI 1659305399
  Medicare reassignment NPD
• Thedacare Medical Center - Shawano, Inc.

  • Critical Access Hospital
  • Shawano, WI
  • NPI 1548260839
  Medicare reassignment NPD
• Aspirus Merrill Hospital & Clinics, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Merrill, WI
  • NPI 1407096266
  NPD
• Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.

  • General Acute Care Hospital
  • Rhinelander, WI
  • NPI 1356391247
  NPD
• MCHS Hospitals Inc

  • Durable Medical Equipment & Medical Supplies
  • Eau Claire, WI
  • NPI 1558230847
  NPD
• Thedacare Medical Center - Shawano, Inc.

  • Community/Retail Pharmacy
  • Shawano, WI
  • NPI 1306516604
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• MCHS Hospitals Inc

  • General Acute Care Hospital
  • Weston, WI
  • NPI 1902437650
  Care Compare affiliation

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541030400000",
    "number": "1295906675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Illinois Ave",
            "address_purpose": "LOCATION",
            "city": "Stevens Point",
            "state": "WI",
            "postal_code": "544813114",
            "country_code": "US",
            "telephone_number": "715-346-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOETTCHER",
        "first_name": "BRADLEY",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-13",
        "last_updated": "2018-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "3411",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "141347",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN SECONDARY WI STATE LICENSE",
            "identifier": "141347",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI STATE LICENSE",
            "identifier": "3411",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon E Boehm, MD
• Katie L Boehm, D-PT
• Marcus A Boehm, DPT
• Jolayne M Boehmke, LPC
• Peter Andrew Boehnlein, COTA
• Stephanie Bohn
• Renee L Bohnart, NP
• Elizabeth Bohrer, PAC
• Melissa Lynn Boldt, FNP-C
• Trisha M Boldt, D-PT

• Certified Registered Nurse Anesthetist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Certified Registered Nurse Anesthetist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; 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.

Verify at the official NPI Registry.