ANTONINO BOMMARITO PA-C
NPI 1396416053
Physician Assistant in Green Bay, WI

Q: What is Antonino Bommarito's NPI number?

The NPI number for Antonino Bommarito is 1396416053. It was assigned to this individual provider in the NPPES registry on September 22, 2021.

Q: What is Antonino Bommarito's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Active since September 22, 2021PECOS EnrolledAccepts Medicare Assignment

1110 KEPLER DR, GREEN BAY, WI 54311(920) 288-5555(920) 288-5550 Get Directions Write a Review

NPPES record last updated: September 26, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 26, 2024, Sep 9, 2024, Feb 25, 2022 and 3 more (6 updates tracked since 2021).

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About Antonino Bommarito Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANTONINO BOMMARITO PA-C (NPI 1396416053) is an individual physician assistant in Green Bay, Wisconsin, licensed in Wisconsin (5614) and active in the NPI registry since September 2021. He is enrolled in Medicare PECOS, is affiliated with Door County Medical Center, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1396416053

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameANTONINO BOMMARITOCredential: PA-C

Location Address1110 KEPLER DRGreen Bay, WI 54311-8306

Mailing Address1035 Kepler DrGreen Bay, WI 54311-8320 · (920) 490-9046

Phone(920) 288-5555

Fax(920) 288-5550

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateSeptember 22, 2021

Last NPPES UpdateSeptember 26, 20246 updates tracked since enumeration

NPPES CertifiedSeptember 26, 2024

✔ NPI 1396416053 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in WI · 5614

Definition

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.

1110 KEPLER DR, Green Bay, WI 54311

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), HealthPartners and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Antonino Bommarito Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5496145526

PECOS Enrollment IDI20211206000183

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

54 services53 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Door County Medical Center

Critical Access Hospitals · Sturgeon Bay, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number521358

Location323 South 18th AvenueSturgeon Bay, WI 54235 · Door County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54311 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ETHAN T SHAVER PA

Physician Assistant