Edward John Bantamoi, MD in Green Bay, WI

Edward John Bantamoi, MD is a medicare enrolled "Family Medicine" physician in Green Bay, Wisconsin. He graduated from medical school in 1996 and has 28 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice St Vincent Hospital-hospital Sisters-third Order Of St Francis and his current practice location is 2502 S. Ashland Ave., Green Bay, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (920) 496-4700.

Edward John Bantamoi is licensed to practice in Wisconsin (license number 48796) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1457376758.

Contact Information

	Edward John Bantamoi, MD
	2502 S. Ashland Ave., Green Bay, WI 54304
	(920) 496-4700
	Not Available

Map and Direction

Physician's Profile

Full Name	Edward John Bantamoi
Gender	Male
Speciality	Family Practice
Experience	28 Years
Location	2502 S. Ashland Ave., Green Bay, Wisconsin
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Edward John Bantamoi graduated from medical school in 1996

NPI Data:

NPI Number: 1457376758
Provider Enumeration Date: 07/13/2006
Last Update Date: 09/18/2017

Medicare PECOS Information:

PECOS PAC ID: 5395730097
Enrollment ID: I20060208000524

Medical Identifiers

Medical identifiers for Edward John Bantamoi such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1457376758	NPI	-	NPPES
34814900	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	48796 (Wisconsin)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
St Vincent Hospital	Green bay, WI	Hospital
St Mary's Hospital Medical Center	Green bay, WI	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
St Vincent Hospital-hospital Sisters-third Order Of St Francis	5799694675	546

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Edward John Bantamoi allows following entities to bill medicare on his behalf.

Entity Name	Prevea Clinic Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1306869276 PECOS PAC ID: 0042123150 Enrollment ID: O20031106000034

Entity Name	St Vincent Hospital-hospital Sisters-third Order Of St Francis
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285613638 PECOS PAC ID: 5799694675 Enrollment ID: O20080620000423

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Edward John Bantamoi is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Edward John Bantamoi, MD Po Box 19070, Green Bay, WI 54307-9070 Ph: (920) 496-4700	Edward John Bantamoi, MD 2502 S. Ashland Ave., Green Bay, WI 54304 Ph: (920) 496-4700

Reviews and Comments

Family Medicine Doctors in Green Bay, WI

Dr. Rachael E. Vanden Langenberg, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3263 Eaton Rd, Green Bay, WI 54311 Phone: 920-433-6700
Bradley Jay Fedderly, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2845 Greenbrier Rd, Green Bay, WI 54311 Phone: 920-288-8100 Fax: 414-762-4225
Amy M Romandine Kratz, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1727 Shawano Ave, Green Bay, WI 54303 Phone: 920-496-4700
Barbara H Franck, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 840 Challenger Dr Ste 191, Green Bay, WI 54311 Phone: 920-412-9737 Fax: 920-489-2247
Matthew Krueger Jenson, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 124 Siegler St, Green Bay, WI 54303 Phone: 920-494-9661 Fax: 920-496-3792
Megan Leigh Grimm, DNP FNP-BC Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1726 Shawano Ave, Green Bay, WI 54303 Phone: 920-884-3135
Trent J Auguston, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3021 Voyager Dr, Green Bay, WI 54311 Phone: 920-496-4700

Edward John Bantamoi, MD - Medicare Family Practice in Green Bay, WI