NPIMap

Individual provider Active NPI

Brandon Charles Bodager, M.D.

  • Diagnostic Radiology Physician
  • Mequon, WI
National Provider Identifier
1811263304
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
61321 Issued in WI
Practice address
10945 N Port Washington Rd Ste 201
Mequon, WI 53092-5078
Phone
(262) 292-3151
NPI assigned
Mar 28, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 61321 WI Primary

Addresses

Primary practice location

10945 N Port Washington Rd Ste 201
Mequon, WI 53092-5078

Mailing address

10945 N Port Washington Rd Ste 201
Mequon, WI 53092-5078
Phone (262) 292-3151

Other identifiers 1

IdentifierTypeStateIssuer
100063658MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bbodager51785@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180612000194 WI Practitioner - Diagnostic Radiology 8628346699 Reassigns benefits to 7 organizations
I20241030000764 IL Practitioner - Diagnostic Radiology 8628346699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Wisconsin, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Medical Clinic LLCGroup PAC ID 7719890730, 375 clinicians
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

2000 E Layton Ave
Saint Francis, WI 53235-6053
Phone (414) 744-6589

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

W231 N1440 Corporate Court
Waukesha, WI 53186-1303
Phone (262) 896-6070

Hospital & facility affiliations

  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
  • Aurora Medical Center Hospital, Grafton, WI, CCN 520207
  • West Allis Memorial Hospital Hospital, West Allis, WI, CCN 520139
  • Aurora Medical Center Kenosha Hospital, Kenosha, WI, CCN 520189
  • Aurora Lakeland Medical Center Hospital, Elkhorn, WI, CCN 520102

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
99.02 of 100Reported as apm
Quality
85.37
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
99.02 of 100Reported as apm
Quality
85.37
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
GBR Sheboygan LLC Diagnostic Radiology CurrentSince Jul 1, 2018 Accepting new patients
Aurora Medical Group, Inc. Diagnostic Radiology Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 1, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 1, 2024 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Oct 1, 2024 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince Oct 1, 2024 Accepting new patients
Wisconsin Radiology Specialists, S C CurrentSince Jul 1, 2020 Accepting new patients
Premier Radiology Wisconsin, LLC Diagnostic Radiology CurrentSince Jul 1, 2020 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Oct 1, 2024 Accepting new patients
Precision Radiology - Illinois LTD CurrentSince Feb 1, 2023 Accepting new patients

Locations

100 N River Rd
Des Plaines, IL 60016
Phone (847) 297-1800

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

2941 S Ridge Rd
Green Bay, WI 54304
Phone (920) 336-4096

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

2323 N Lake Dr
Milwaukee, WI 53211
Phone (414) 291-1000

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

10180 Washington Ave
Mount Pleasant, WI 53177
Phone (414) 769-4040

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

10945 N Port Washington Rd
Ste 201
Thiensville, WI 53092
Phone (262) 478-0301

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

W231N1440 Corporate Ct
Waukesha, WI 53186
Phone (262) 896-6000

Interoperability endpoints

  • Direct secure messaging: bbodager51785@direct.myadvocateaurora.org

Organizations & group practices 34

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.

View all 34

Hospital & facility affiliations 7

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": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1811263304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10945 N PORT WASHINGTON RD STE 201",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925078",
            "telephone_number": "262-292-3151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10945 N PORT WASHINGTON RD STE 201",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925078",
            "telephone_number": "262-292-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODAGER",
        "first_name": "BRANDON",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-28",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "61321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100063658",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bbodager51785@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10945 N Port Washington Rd Ste 201",
            "city": "Mequon",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530925078",
            "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": "10945 N Port Washington Rd Ste 201",
            "city": "Mequon",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530925078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

Verify at the official NPI Registry.