Individual provider Active NPI

William S. Bodemer, M.D.

  • Orthopaedic Surgery Physician
  • Appleton, WI
National Provider Identifier
1497705370
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
44737 Issued in WI
Practice address
5320 W Michaels Dr
Appleton, WI 54913
Phone
(920) 882-8200
Fax
(920) 882-8210
NPI assigned
May 11, 2006
Last updated
Oct 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X TL1091 WY
Orthopaedic Surgery Physician 207X00000X 44737 WI Primary

Addresses

Primary practice location

5320 W Michaels Dr
Appleton, WI 54913

Mailing address

5320 W Michaels Dr
Appleton, WI 54913-8446
Phone (920) 882-8200

Other identifiers 1

IdentifierTypeStateIssuer
100011384MedicaidWI

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100910000828 WI Practitioner - Orthopedic Surgery 4981704483 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Wisconsin School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Clinics of Wisconsin SCGroup PAC ID 5092842658, 4 clinicians

Practice addresses (Care Compare)

200 Division St
Suite J
Stevens Point, WI 54481-1843
Phone (715) 544-1774

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
70.83 of 100Reported as group
Quality
48.15
Promoting interoperability
100
Improvement activities
40
Cost
54.62

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Laminectomy or laminotomy (partial removal of spine bones)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
44737WIMDOrthopaedic Surgery Physician
TL1091WYMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurospine Center of Wisconsin, S.C. CurrentSince Aug 8, 2018 Accepting new patients
Orthopedic Associates of Sauk Prairie S.C. Orthopaedic Surgery Past Accepting new patients

Locations

5320 W Michaels Dr
Grand Chute, WI 54913
Phone (920) 735-7650

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

1380 Tullar Rd
Neenah, WI 54956
Phone (920) 205-0379

Organizations & group practices 3

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

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1497705370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5320 W MICHAELS DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138446",
            "telephone_number": "920-882-8200",
            "fax_number": "920-882-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 W MICHAELS DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54913",
            "telephone_number": "920-882-8200",
            "fax_number": "920-882-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODEMER",
        "first_name": "WILLIAM",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WY",
            "license": "TL1091",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "44737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100011384",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.