NPIMap

Organization Active NPI

Baycare Clinic, LLP

  • Durable Medical Equipment & Medical Supplies
  • Manitowoc, WI
National Provider Identifier
1376129833
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
BAYCARE CLINIC, LLP
Practice address
1111 Bayshore Dr
Manitowoc, WI 54220-5548
Phone
(920) 490-9046
Fax
(920) 405-8005
NPI assigned
Mar 23, 2021
Last updated
Aug 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1111 Bayshore Dr
Manitowoc, WI 54220-5548

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 IDStateProvider typePAC IDDetails
O20211025002721 WI DME Supplier - Physician - Orthopedic/Orthopedic SurgeryDME Supplier - Physician - Ophthalmology 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).

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D1053145Baycare Clinic, LLP1111 Bayshore Dr, Manitowoc, WI 54220Certificate of waiverApr 13, 2028

National Provider Directory

National Provider Directory
Tax ID family
Linda Zaffke11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787788800000",
    "number": "1376129833",
    "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",
            "fax_number": "920-405-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 BAYSHORE DR",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542205548",
            "telephone_number": "920-490-9046",
            "fax_number": "920-405-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYCARE CLINIC, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-23",
        "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": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic 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.

Verify at the official NPI Registry.