Jeffrey Joseph Bongiorno, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

798025 Issued in WI

Practice address

1317 W Grand Ave
Port Washington, WI 53074-2075

Phone

(262) 284-8800

Fax

(262) 284-8861

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

William M. Scholl College of Podiatric Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Port Washington Podiatry Inc

  • Podiatrist
  • Port Washington, WI
  • NPI 1013953926
  Medicare reassignment NPD Authorized official
• Cornerstone Counseling Services, Inc

  • Mental Health Counselor
  • Brookfield, WI
  • NPI 1033127246
  NPD
• Dr. Steven M Waldman S.C.

  • Podiatrist
  • Wauwatosa, WI
  • NPI 1376626267
  NPD (past)
• Horizon Home Care & Hospice, Inc.

  • Home Health Agency
  • Milwaukee, WI
  • NPI 1780687327
  NPD (past)
• North Shore Podiatry, Inc.

  • Podiatrist
  • Milwaukee, WI
  • NPI 1295819118
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195430400000",
    "number": "1770599953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2132 WILLOW POND WAY",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530249102",
            "telephone_number": "262-268-1789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 W GRAND AVE",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "530742075",
            "telephone_number": "262-284-8800",
            "fax_number": "262-284-8861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONGIORNO",
        "first_name": "JEFFREY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WI",
            "license": "798025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "P00085509",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41755100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43227800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "4998210001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra E Black, LCSW
• Roger Blanchard, MSW, LCSW
• Cameron Blegen, M.D.
• Sara Bodenhamer, D.O.
• John P Bonavia, MD
• Abigail G Bonness
• Mark S Bostwick, MD
• Teresa Lin Braun, MS, CCC-SLP
• Heather Kay Brede
• Emily Brennan

• Podiatrist in Port Washington, WI
• Providers in Port Washington, WI by specialty
• Podiatrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; 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.