JACQUELINE KALIS BOHANKO PA-C
NPI 1760631279
Physician Assistant - Medical in Cinnaminson, NJ

Q: What is Jacqueline Bohanko's NPI number?

The NPI number for Jacqueline Bohanko is 1760631279. It was assigned to this individual provider in the NPPES registry on September 9, 2008.

Q: What is Jacqueline Bohanko's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Active since September 09, 2008PECOS EnrolledAccepts Medicare Assignment

2099 NEW ALBANY RD, CINNAMINSON, NJ 08077(099) 268-8996(856) 772-1997 Get Directions Write a Review

NPPES record last updated: September 17, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 17, 2024, Feb 15, 2017 (2 updates tracked since 2017).

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About Jacqueline Kalis Bohanko Pa-c NPPES

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

JACQUELINE KALIS BOHANKO PA-C (NPI 1760631279) is an individual medical provider in Cinnaminson, New Jersey, licensed in Pennsylvania (MA053571) and active in the NPI registry since September 2008. She is enrolled in Medicare PECOS and is a graduate of Drexel University College Of Medicine (2008).

NPPES Registry Identity

NPI1760631279

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameJACQUELINE KALIS BOHANKOCredential: PA-C

Location Address2099 NEW ALBANY RDCinnaminson, NJ 08077-3534

Mailing Address2099 New Albany RdCinnaminson, NJ 08077-3534 · (609) 926-8899 · Fax (856) 772-1997

Phone(099) 268-8996

Fax(856) 772-1997

Sole ProprietorNo

Medical School CMSDrexel University College Of MedicineGraduated 2008

Enumeration DateSeptember 9, 2008

Last NPPES UpdateSeptember 17, 20242 updates tracked since enumeration

NPPES CertifiedSeptember 17, 2024

✔ NPI 1760631279 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in PA · MA053571

Also ListedPhysician AssistantTaxonomy 363A00000X · License 25MP00879200 (NJ)

2099 NEW ALBANY RD, Cinnaminson, NJ 08077

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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

Jacqueline Kalis Bohanko 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 ID2961556345

PECOS Enrollment IDI20090819000738, I20241024002239

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.

Other Providers at the Same Location NPPES 11

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

DR. LAWRENCE AHR MD

Pediatrics