Edward J Bongiorno, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4508 Issued in WI

Practice address

1630 Commanche Ave
Green Bay, WI 54313-5753

Phone

(920) 430-4700

NPI assigned

Dec 5, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal MedicineAlso: Pediatric Medicine

Education

Midwestern University, Chicago College of Osteopathic Med, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bellin Home Health Agency Home health agency, Green Bay, WI, CCN 527089
• Unity Hospice Hospice, De Pere, WI, CCN 521503
• Bellin Memorial Hospital Hospital, Green Bay, WI, CCN 520049
• Osf St Francis Hospital and Medical Group Hospital, Escanaba, MI, CCN 231337
• Rennes Health and Rehab Center-De Pere Nursing home, De Pere, WI, CCN 525573
• Woodside Lutheran Home Nursing home, Green Bay, WI, CCN 525557

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ebongiorno916910@direct.emplifyhealth.org
• Direct secure messaging: ebongiorno30738@direct.thedacare.org

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.

• Bellin Memorial Hospital Inc

  • Rural Health Clinic/Center
  • Algoma, WI
  • NPI 1609838473

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Apogee Medical Group, Wisconsin, S.C

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1629415591

  WI

  Medicare reassignment NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1033172390
  NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Pulaski, WI
  • NPI 1609838390
  NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Brillion, WI
  • NPI 1962464784
  NPD (past)

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

• Bay Area Lutheran Homes Inc

  • Skilled Nursing Facility
  • Green Bay, WI
  • NPI 1780756890

  Nursing home

  Care Compare affiliation
• Bellin Memorial Hospital Inc

  • Home Health Agency
  • Green Bay, WI
  • NPI 1831246404
  Care Compare affiliation
• Bellin Memorial Hospital Inc.

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1891740585
  Care Compare affiliation
• TDR Inc

  • Skilled Nursing Facility
  • De Pere, WI
  • NPI 1932107422

  Nursing home

  Care Compare affiliation
• Unity Limited Partnership

  • Community Based Hospice Care Agency
  • De Pere, WI
  • NPI 1194797910
  Care Compare affiliation
• St Francis Hospital

  • Critical Access Hospital
  • Escanaba, MI
  • NPI 1922058551
  Care Compare affiliation

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393459200000",
    "number": "1992789754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 COMMANCHE AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543135753",
            "telephone_number": "920-430-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 COMMANCHE AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543135753",
            "telephone_number": "920-430-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONGIORNO",
        "first_name": "EDWARD",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2014-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "4508",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "45808",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "45808",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43507600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amie Rose Bomber
• Steven A Bomkamp, APNP
• Antonino Bommarito, PA-C
• Lynn Marie Bond, PHARMACIST
• Katherine Ann Bongel, LPN
• Andrea Bonnin
• Julie Bonnin, MD
• April C Borchardt, DPM
• Denise Borchardt, PT
• Dianna L Bordewick, MD

• Internal Medicine Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2014; 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.