Lisa S Bosshard, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

41313 Issued in WI

Practice address

611 Veterans Ave Ste 106
West Bend, WI 53090-2545

Phone

(262) 353-4460

Fax

(262) 353-4461

NPI assigned

Aug 7, 2006

Last updated

Mar 7, 2023By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lbosshard8320@direct.chw.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.

• Children's Medical Group

  dba Glendale Pediatrics

  • Pediatrics Physician
  • Glendale, WI
  • NPI 1134394471
  NPD (past)
• Children's Medical Group

  dba West Bend Pediatrics

  • Pediatrics Physician
  • West Bend, WI
  • NPI 1992171987
  NPD (past)

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1912916891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W. WISCONSIN AVENUE",
            "address_2": "MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-7615",
            "fax_number": "414-266-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 VETERANS AVE STE 106",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530902545",
            "telephone_number": "262-353-4460",
            "fax_number": "262-353-4461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSSHARD",
        "first_name": "LISA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "41313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912916891",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Marie Bohn
• Julie Bolha, PPCNP-BC
• Bordeaux SLP & Consulting, LLC (Mke SLP)
• Andrew Russell Bordeaux, M.S., CCC-SLP
• Allyssa L Bosse, LPC
• Irene Isabel Bozich, M.D.
• Lenore Elizabeth Brahm, DO
• Sarah Braun Otten, MS
• Kristin Brei
• Carmon Breitlow, PHARMD

• Pediatrics Physician in West Bend, WI
• Providers in West Bend, WI by specialty
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.