John L Bostanche, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

654025 Issued in WI

Practice address

6123 Green Bay Rd
Ste 100
Kenosha, WI 53142-2939

Phone

(262) 657-3668

Fax

(262) 652-0564

NPI assigned

Jun 10, 2005

Last updated

May 5, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aurora Medical Center Kenosha Hospital, Kenosha, WI, CCN 520189

Merit-based Incentive Payment System (MIPS)

Final score

96.85 of 100Reported as group

Quality

88.87

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Great Lakes Foot & Ankle Centers Inc

  • Foot & Ankle Surgery Podiatrist
  • Kenosha, WI
  • NPI 1295941409
  Medicare reassignment NPD Authorized official
• Great Lakes Medical LLC

  • Ambulatory Surgical Clinic/Center
  • Franklin, WI
  • NPI 1497980759
  Authorized official Same address or phone
• Family Foot & Ankle Clinics of Wisconsin LLC

  • Primary Podiatric Medicine Podiatrist
  • Kenosha, WI
  • NPI 1235561473

  Foot & Ankle Surgery

  NPD (past)

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

• Aurora Health Care Southern Lakes, Inc.

  • General Acute Care Hospital
  • Kenosha, WI
  • NPI 1225156888
  Care Compare affiliation

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273017600000",
    "number": "1821092420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6123 GREEN BAY RD",
            "address_2": "STE 100",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531422939",
            "telephone_number": "262-657-3668",
            "fax_number": "262-652-0564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6123 GREEN BAY RD",
            "address_2": "STE 100",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531422939",
            "telephone_number": "262-657-3668",
            "fax_number": "262-652-0564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTANCHE",
        "first_name": "JOHN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2010-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WI",
            "license": "654025",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016004510",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43215000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karla S. Boho, N.P.
• Kelsey Lynn Bohr, NP
• Kimberly Ann Bollmeier, PHYSICIAN ASSISTANT
• Louise A Borst, RPH CGP
• Brienna Marie Bostanche, DPM
• Brian Daniel Boston, DMD
• Rommel Ortiz Bote', M.D.
• Ami Bouterse
• Robert Bruce Bower, OD
• Katie Lynn Bowers, ATC, LAT, CSCS

• Foot & Ankle Surgery Podiatrist in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Foot & Ankle Surgery Podiatrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2010; 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.