Colleen Bonkowski, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

44540 Issued in WI

Practice address

3237 S 16TH St
Radiology Dept. 2ND Floor
Milwaukee, WI 53215-4526

Phone

(414) 647-5132

NPI assigned

May 4, 2006

Last updated

Nov 24, 2021By the provider in NPPES

Sex

Female

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

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cbonkowski176428@direct.myadvocateaurora.org

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.

• Aurora Advanced Healthcare, Inc.

  • Family Medicine Physician
  • Milwaukee, WI
  • NPI 1265629133
  Medicare reassignment NPD
• Aurora Medical Group, Inc.

  • Certified Registered Nurse Anesthetist
  • Milwaukee, WI
  • NPI 1427271378

  Diagnostic Radiology

  Medicare reassignment NPD
• Lakeshore Medical Clinic, LLC

  • Family Medicine Physician
  • St Francis, WI
  • NPI 1003861188
  Medicare reassignment NPD
• Aurora Advanced Healthcare Inc

  • Durable Medical Equipment & Medical Supplies
  • Summit, WI
  • NPI 1477186633
  NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD
• Commonwealth Medical Group, LLC

  • Internal Medicine Physician
  • West Allis, WI
  • NPI 1477500361

  Diagnostic Radiology

  NPD (past)
• St. Luke's Health Services, Inc.

  • Obstetrics & Gynecology Physician
  • Racine, WI
  • NPI 1215119706
  NPD (past)

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1508814286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2646 N LAKE DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532113837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3237 S 16TH ST",
            "address_2": "RADIOLOGY DEPT. 2ND FLOOR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154526",
            "telephone_number": "414-647-5132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONKOWSKI",
        "first_name": "COLLEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "44540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34237300",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cbonkowski176428@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3237 S 16th St",
            "address_2": "Radiology Dept. 2nd Floor",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532154526",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3237 S 16th St",
            "address_2": "Radiology Dept. 2nd Floor",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532154526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Genna Catherine Bonfiglio, MD
• Hannah Lea Bonikowske
• Marilyn Jeanne Bonjean, ED.D.
• Ronald Dean Bonjean, PH.D.
• Abigail Bonjour
• Alexandria Lee Bonne
• Valerie Jean Bonne, M.D.
• Julia Bonner, M.D.
• Michael H. Bonner, M.D.
• Theodore Bonner, MD

• Diagnostic Radiology Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Diagnostic Radiology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.