Brian R Raguse, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1663 Issued in WI

Practice address

1160 Kepler Dr
Green Bay, WI 54311

Phone

(920) 288-5555

Fax

(920) 288-5550

NPI assigned

Aug 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Froedtert Manitowoc Medical Group, LLCGroup PAC ID 2365836954, 156 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Family Memorial Hospital, Manitowoc, WI, CCN 520107

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: braguse538259@direct.froedtert.com

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.

• Froedtert Manitowoc Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Manitowoc, WI
  • NPI 1437829975
  Medicare reassignment Care Compare group

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

• Holy Family Memorial Inc

  • General Acute Care Hospital
  • Manitowoc, WI
  • NPI 1700998697
  Care Compare affiliation

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222732800000",
    "number": "1316959083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 KEPLER DR",
            "address_2": "PO BOX 8970",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543088970",
            "telephone_number": "920-288-5555",
            "fax_number": "920-288-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 KEPLER DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54311",
            "telephone_number": "920-288-5555",
            "fax_number": "920-288-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGUSE",
        "first_name": "BRIAN",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2008-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41980900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Marie Radke, PTA
• Andrew Chandler Radtke, MD
• Diane Radtke, PT
• Carol A. Rafferty, NP
• Matthew Kyle Rafn, MD
• Brianna Rahmlow
• Ashok Nand Rai, MD
• Carmel Joy Raihala, DC CCSP
• Brenna Rainey, PHARMD
• Anne Marie Rainsford, APNP

• Physician Assistant in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.