DR. JOHN L BOSTANCHE (NPI# 1821092420) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821092420 |
| Entity Type | Individual |
| Full Name | DR. JOHN L BOSTANCHE |
| Credential | D.P.M. |
| Practice Address |
6123 Green Bay Rd Ste 100 Kenosha WI 53142-2939 |
| Practice Telephone | 2626573668 |
| Practice Fax Number | 2626520564 |
| Mailing Telephone | 2626573668 |
| Mailing Fax Number | 2626520564 |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2010-05-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
016004510 | IL | Podiatric Medicine & Surgery Service Providers |
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
654025 | WI | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 43215000 | 05 |
| Street Address |
6123 GREEN BAY RD STE 100 |
| City | KENOSHA |
| State | WI |
| Zip Code | 53142-2939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770842213 | Todd's Companionplus Inc. | In Home Supportive Care | 6123 Green Bay Rd, Suite 250, Kenosha, WI 53142-2927 | 2012-05-03 |
| 1104127372 | Rodrigo A Mata Jr. | Family Medicine | 6123 Green Bay Rd, Suite 120, Kenosha, WI 53142-2927 | 2010-11-04 |
| 1720303332 | Chad E Sloden | Chiropractor | 6123 Green Bay Rd, Kenosha, WI 53142-2927 | 2010-04-07 |
| 1700045168 | Great Lakes Surgery Center LLC | Clinic/Center | 6123 Green Bay Rd, Suite 100, Kenosha, WI 53142-2927 | 2008-06-02 |
| 1093900136 | Great Lakes Family Medical Center Inc | Clinic/Center | 6123 Green Bay Rd, Suite 120, Kenosha, WI 53142-2927 | 2007-09-12 |
| 1295941409 | Great Lakes Foot & Ankle Centers Inc | Podiatrist | 6123 Green Bay Rd, Suite 100, Kenosha, WI 53142-2927 | 2007-05-15 |
| 1053468397 | Tarey Ann Wenninger | Physical Therapist | 6123 Green Bay Rd, Suite 140, Kenosha, WI 53142-2927 | 2007-01-05 |
| 1649291923 | Kalpana Rao | Psychologist | 6123 Green Bay Rd, Kenosha, WI 53142-2927 | 2006-07-21 |
| 1033148176 | Rodrigo Buencamino Mata IIi | Internal Medicine | 6123 Green Bay Rd, Suite 120, Kenosha, WI 53142-2927 | 2006-07-01 |
| 1801882451 | Back-in-action Physical Therapy Center of Kenosha, Ltd. | Physical Therapist | 6123 Green Bay Rd, Ste 140, Kenosha, WI 53142-2927 | 2005-09-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588297816 | Caring Hearts Home Health Care | In Home Supportive Care | 6021-57th Ave, Suite C103, Kenosha, WI 53142 | 2020-02-14 |
| 1144785395 | Michael L Wrzesinski | Counselor | 4109 67th Street, Kenosha, WI 53142 | 2019-02-01 |
| 1720538499 | David Smith | Counselor | 10900 67th Street, Kenosha, WI 53142 | 2016-10-06 |
| 1326404641 | Smile Doctors Ltd | Dentist | 7003 39th Ave, Kenosha, WI 53142 | 2016-01-04 |
| 1225409485 | Antonia Marie Decker | Physician Assistant | 10400 75th St. Ste 204, Kenosha, WI 53142 | 2015-10-14 |
| 1780060582 | Joshua Haas | Pharmacist | 7701 Green Bay Road, Kenosha, IL 53142 | 2015-08-04 |
| 1811379225 | Dana Mary Stout | Registered Nurse | 7401 104th Avenue, Suite 110, Comprehensive Orthopaedics, S.c., Kenosha, WI 53142 | 2015-06-22 |
| 1669815569 | Joshua Knute Elson | Radiology | 6811 118th Ave, Kenosha, WI 53142 | 2013-04-10 |
| 1356610166 | Michael J Gallo | Pharmacist | 7535 North Greenbay Rd, Kenosha, WI 53142 | 2011-12-22 |
| 1720357999 | Orest Carnevale | Registered Nurse | 7316 155th Ct, Kenosha, WI 53142 | 2011-12-18 |
| Find all providers in zip 53142 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124688114 | Foot Factor Podiatry LLC | Podiatrist | 6125 Green Bay Rd Ste 600, Kenosha, WI 53142-2928 | 2019-06-20 |
| 1477758035 | Matthew D Sorensen | Podiatrist | 10105 74th St Ste 101, Kenosha, WI 53142 | 2007-06-15 |
| 1710996475 | H.r. Reinherz Dpm,sc | Podiatrist | 6801 Sheridan Rd, Kenosha, WI 53143-1321 | 2006-08-05 |
| 1518394550 | Family Foot & Ankle Clinics of Wisconsin,llc | Podiatrist | 3535 30th Ave, Ste 203, Kenosha, WI 53144-1632 | 2013-10-05 |
| 1487957155 | E Bruns Foot and Ankle Sc | Podiatrist | 9916 75th St, Suite 201, Kenosha, WI 53142-7583 | 2010-12-17 |
| 1770819567 | William Allen Yoder | Podiatrist | 3535 30th Ave, Suite 203, Kenosha, WI 53144-1632 | 2009-10-28 |
| 1417141227 | Family Foot Clinics of Wisconsin Sc | Podiatrist | 3535 30th Ave, #203, Kenosha, WI 53144-1632 | 2007-09-05 |
| 1295941409 | Great Lakes Foot & Ankle Centers Inc | Podiatrist | 6123 Green Bay Rd, Suite 100, Kenosha, WI 53142-2927 | 2007-05-15 |
| 1356418800 | Wisconsin Foot & Ankle Center LLC | Podiatrist | 10105 74th St, Suite 101, Kenosha, WI 53142-7519 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225675697 | Grayco LLC | Podiatrist | 7128 Tamarack Ct, Mequon, WI 53092-8517 | 2019-12-04 |
| 1063928752 | Sheboygan Foot Care, LLC | Podiatrist | 630 Riverfront Dr Ste 202, Sheboygan, WI 53081-4616 | 2017-12-18 |
| 1295279461 | Colin T Graney | Podiatrist | 664 W. Washington Ave, Madison, WI 53703 | 2016-12-07 |
| 1790158368 | Wisconsin Visiting Podiatry | Podiatrist | 28606 Sandpiper Trl, Waterford, WI 53185-1733 | 2015-11-04 |
| 1225415540 | Alexander Blaschke | Podiatrist | 1009 Caledonia St, La Crosse, WI 54603 | 2015-05-06 |
| 1164861712 | Jessica Leigh Minder | Podiatrist | W62n179 Washington Ave Ste 3, Cedarburg, WI 53012-2770 | 2013-06-17 |
| 1326322884 | Northwoods Foot & Ankle LLC | Podiatrist | 1400 Us Highway 51 N, Unit G, Arbor Vitae, WI 54568-9504 | 2011-10-03 |
| 1336434075 | James David Torhorst | Podiatrist | 1439 Churchill St # 202, Waupaca, WI 54981-2089 | 2011-06-10 |
| 1154632412 | Anton John Sella | Podiatrist | 2835 N Grandview Blvd Ste 300, Pewaukee, WI 53072-5591 | 2010-07-01 |
| 1861627184 | Ivelisse Vargas Jon | Podiatrist | 6510 W Layton Ave Ste 102, Greenfield, WI 53220-4563 | 2009-05-17 |
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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.