EDWARD JOHN BANTAMOI MD
NPI 1457376758
Family Medicine in Green Bay, WI

Active since July 13, 2006PECOS EnrolledAccepts Medicare Assignment
94.61/100
CMS Quality Rating
2502 S. ASHLAND AVE., GREEN BAY, WI 54304(920) 496-4700 Get Directions Write a Review

NPPES record last updated: September 18, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Edward John Bantamoi Md NPPES

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

EDWARD JOHN BANTAMOI MD (NPI 1457376758) is an individual family medicine provider in Green Bay, Wisconsin, licensed in Wisconsin (48796) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with St Vincent Hospital, and is a graduate of Other (1996).

NPPES Registry Identity

NPI1457376758
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameEDWARD JOHN BANTAMOICredential: MD
Location Address2502 S. ASHLAND AVE.Green Bay, WI 54304
Mailing AddressPo Box 19070Green Bay, WI 54307-9070 · (920) 496-4700
Sole ProprietorNo
Medical School CMSOtherGraduated 1996
Enumeration DateJuly 13, 2006
Last NPPES UpdateSeptember 18, 2017
NPI 1457376758 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in WI · 48796
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2502 S. ASHLAND AVE., Green Bay, WI 54304

Other Identifiers 3

Medicare UPINH84490
Medicare ID-Type Unspecified07125-0327
Medicaid34814900WI

Accepted 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

Edward John Bantamoi Md 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 ID5395730097
PECOS Enrollment IDI20060208000524
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 6

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.

Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
156 services95 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
149 services94 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
41 services41 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
35 services26 patients
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.
34 services31 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

St Vincent Hospital

Acute Care Hospitals · Green Bay, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520075
Location835 S Van Buren StGreen Bay, WI 54301 · Brown County
Emergency services Birthing friendly

St Mary's Hospital Medical Center

Acute Care Hospitals · Green Bay, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number520097
Location1726 Shawano AveGreen Bay, WI 54303 · Brown County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54304 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
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.17
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 6

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
9 suppliers41 claims68 services$4.85 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers16 claims16 services$0.78 avg. paid by Medicare
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
2 suppliers13 claims390 services$5.96 avg. paid by Medicare
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4150
Other-Enteral and Parenteral · category OB006N
2 suppliers13 claims5,775 services$0.30 avg. paid by Medicare
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620
DME-Drugs Administered Through DME · category DG006N
3 suppliers18 claims1,780 services$0.09 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
2 suppliers13 claims13 services$24.09 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 9

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

Physical Therapist
2502 S. ASHLAND AVE.
GREEN BAY, WI 54304
Physical Therapist
2502 S. ASHLAND AVE.
GREEN BAY, WI 54304
Physician Assistant
2502 S. ASHLAND AVE.
GREEN BAY, WI 54304
Orthopaedic Surgery
2502 S. ASHLAND AVE.
GREEN BAY, WI 54304
Physical Therapist
2502 S. ASHLAND AVE.
GREEN BAY, WI 54304
Physical Therapist
2502 S. ASHLAND AVE.
GREEN BAY, WI 54304
Physical Therapist
2502 S. ASHLAND AVE.
GREEN BAY, WI 54304
Physical Therapist
2502 S. ASHLAND AVE.
GREEN BAY, WI 54304

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edward Bantamoi's NPI number?

The NPI number for Edward Bantamoi is 1457376758. It was assigned to this individual provider in the NPPES registry on July 13, 2006.

Where is Edward Bantamoi located?

Edward Bantamoi practices at 2502 S. Ashland Ave., Green Bay, WI 54304. The listed phone number is (920) 496-4700.

What is Edward Bantamoi's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Edward Bantamoi enrolled in Medicare?

Yes. Edward Bantamoi is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Edward Bantamoi accept?

Health plans from Anthem Blue Cross and Blue Shield and Network Health list Edward Bantamoi as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Edward Bantamoi affiliated with any hospitals?

According to CMS data, Edward Bantamoi is affiliated with St Vincent Hospital and St Mary's Hospital Medical Center.

When was this NPI record last updated?

The NPPES record for Edward Bantamoi was last updated on September 18, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.