JASON BONFIGLIO (NPI# 1134726433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134726433 |
| Entity Type | Individual |
| Full Name | JASON BONFIGLIO |
| Credential | PA |
| Practice Address |
800 Riverside Dr Waupaca WI 54981-1943 |
| Mailing Address |
405 Bishops Way Unit 629 Brookfield WI 53005-6261 |
| Practice Telephone | 7152581000 |
| Mailing Telephone | 4145883405 |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2020-10-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
800 RIVERSIDE DR |
| City | WAUPACA |
| State | WI |
| Zip Code | 54981-1943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861475006 | Robert Ray Schrope Iv | Physician Assistant | 800 Riverside Dr, Waupaca, WI 54981-1943 | 2005-11-22 |
| 1528627239 | Jessica L Abraham | Physician Assistant | 800 Riverside Dr, Waupaca, WI 54981-1943 | 2019-06-07 |
| 1942785712 | Daniel Haugly | Physical Therapist | 800 Riverside Dr, Waupaca, WI 54981 | 2018-09-27 |
| 1851884340 | Kimberley R Schneider | Physical Therapist | 800 Riverside Dr, Waupaca, WI 54981-1943 | 2018-06-11 |
| 1376082628 | Jennifer Rose Draeger | Occupational Therapist | 800 Riverside Dr, Waupaca, WI 54981-1943 | 2017-02-20 |
| 1609320555 | Adam Michael Irwin | Physical Therapist | 800 Riverside Dr, Waupaca, WI 54981-1943 | 2016-08-09 |
| 1982055026 | Amanda Margaret Probasco | Physician Assistant | 800 Riverside Dr, Waupaca, WI 54981-1943 | 2016-06-30 |
| 1801240858 | Jamie Lynn Schneider | Emergency Medicine | 800 Riverside Dr, Waupaca, WI 54981 | 2016-04-15 |
| 1992110399 | Thedacare Medical Center - Waupaca, Inc. | Clinical Medical Laboratory | 800 Riverside Dr, Waupaca, WI 54981-1943 | 2014-06-24 |
| 1558618595 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 800 Riverside Dr, Waupaca, WI 54981-1943 | 2012-08-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366096141 | Renee Elizabeth Winn | Speech-Language Pathologist | 800 Riverside Drive Dr. 902 Building, Speech Therapy, Waupaca, WI 54981 | 2019-07-30 |
| 1891263216 | Stephanie Rice | Dental Hygienist | N4008 Morgan Dr, Waupaca, WI 54981 | 2018-11-03 |
| 1972092989 | Renew Physical Therapy and Wellness, LLC | Physical Therapist | N2919 County Road Qq, Waupaca, WI 54981 | 2018-05-04 |
| 1366942195 | Lanna Boyle | Physical Medicine & Rehabilitation | E1132 Hillcrest Dr, Waupaca, WI 54981 | 2018-02-19 |
| 1710333893 | Thedacare Medical Center - Waupaca, Inc. | General Acute Care Hospital | N2610 Wi 22, Waupaca, WI 54981 | 2016-05-09 |
| 1750743365 | Kimberly Marie Kraeger | Counselor | Waupaca County Dhhs, 811 Harding St, Waupaca, WI 54981 | 2016-03-23 |
| 1619211596 | Kari Anna Esbensen | Counselor | N2919 Cty Qq, Waupaca, WI 54981 | 2012-11-16 |
| 1396027629 | Roots Wholistic Health | Chiropractor | 717 Churchill St., Waupaca, WI 54981 | 2011-09-13 |
| 1629387006 | Barton Jerome Blum | General Practice | E1803 Melody Lane, Waupaca, WI 54981 | 2010-10-01 |
| 1710219357 | Anne Marie Collins-reed | Social Worker | 315 River Road, New London, WI 54981 | 2010-02-08 |
| Find all providers in zip 54981 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861475006 | Robert Ray Schrope Iv | Physician Assistant | 800 Riverside Dr, Waupaca, WI 54981-1943 | 2005-11-22 |
| 1528627239 | Jessica L Abraham | Physician Assistant | 800 Riverside Dr, Waupaca, WI 54981-1943 | 2019-06-07 |
| 1003479494 | Andrew Kubisch | Physician Assistant | 710 Riverside Dr, Waupaca, WI 54981 | 2019-04-21 |
| 1982055026 | Amanda Margaret Probasco | Physician Assistant | 800 Riverside Dr, Waupaca, WI 54981-1943 | 2016-06-30 |
| 1245606029 | Katherine Margaret Miller | Physician Assistant | 710 Riverside Dr, Waupaca, WI 54981-1941 | 2015-08-17 |
| 1699089698 | Blair M Rathjen | Physician Assistant | 710 Riverside Dr, Waupaca, WI 54981-1941 | 2010-08-02 |
| 1710167671 | Tammy S Elgersma | Physician Assistant | 710 Riverside Dr, Waupaca, WI 54981-1941 | 2007-11-08 |
| 1275655797 | Kara J. Enerson | Physician Assistant | 710 Riverside Dr, Waupaca, WI 54981-1941 | 2007-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811409 | Kristen T Razner | Physician Assistant | 2500 E Capitol Dr # 3700, Appleton, WI 54911-8735 | 2020-11-03 |
| 1659986677 | Jordana Butler | Physician Assistant | 2105 E Enterprise Ave # 101, Appleton, WI 54913-7862 | 2020-09-15 |
| 1952916108 | Nicholas Allan Lueddecke | Physician Assistant | 101709 Fence Rd, Abbotsford, WI 54405-5400 | 2020-09-14 |
| 1073127049 | Dana Van De Hey | Physician Assistant | 616 White Birch Ct, Appleton, WI 54915-4516 | 2020-09-07 |
| 1386257194 | Harrison R Pham | Physician Assistant | 214 E Florida St Apt 526, Milwaukee, WI 53204-1657 | 2020-08-31 |
| 1366055063 | Clai Bishop Catto | Physician Assistant | 902c Tainter St, Menomonie, WI 54751-1546 | 2020-08-24 |
| 1003434978 | Benjamin Alton Cuvelier | Physician Assistant | 132 Cambridge Ave Apt 407, Waukesha, WI 53188-4788 | 2020-07-08 |
| 1366060295 | Sarah Anne Cook | Physician Assistant | 850 Brinsmere Dr, Elm Grove, WI 53122-2101 | 2020-07-07 |
| 1275159428 | Breanna Evert | Physician Assistant | 2320 Parklawn Dr # C111, Waukesha, WI 53186-2954 | 2020-06-23 |
| 1376168443 | Sadie Kolodziej | Physician Assistant | 401 Dewey Dr, Stevens Point, WI 54482-9655 | 2020-06-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.