KENNETH B. BORTIN (NPI# 1861554743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861554743 |
| Entity Type | Individual |
| Full Name | KENNETH B. BORTIN |
| Credential | MD |
| Practice Address |
N2950 State Road 67 Lake Geneva WI 53147-2655 |
| Practice Telephone | 2622454990 |
| Practice Fax Number | 2622452655 |
| Mailing Telephone | 2622454990 |
| Mailing Fax Number | 2622452655 |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2016-08-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
26253-20 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 30583300 | 05 |
| Street Address |
N2950 STATE ROAD 67 |
| City | LAKE GENEVA |
| State | WI |
| Zip Code | 53147-2655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386631281 | Shweta Pearlstein | Anesthesiology | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2005-10-05 |
| 1154928547 | Jessica M Grubb | Occupational Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2020-10-08 |
| 1063072650 | Madalyn R Douglas | Physical Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2019-06-17 |
| 1013421908 | Ashley E. Boro | Occupational Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-11-30 |
| 1447776950 | Stefanie N Droese | Physical Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-08-16 |
| 1427573773 | Andrea M. Lysaght | Registered Nurse | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-08-08 |
| 1265956288 | Kyle C. Janicke | Physical Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-08-01 |
| 1164952891 | Carling M. Johns | Physical Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-06-15 |
| 1730615030 | Deborah Lynn Young | Registered Nurse | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-05-04 |
| 1386180255 | Shelly M Weis | Physical Therapist | N2950 State Road 67, Lake Geneva, WI 53147-2655 | 2017-01-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356951206 | Emily Tanis | Physical Therapist | 6722 Wi-50, Lake Geneva, WI 53147 | 2020-08-05 |
| 1588295653 | Baylee M Noe | Occupational Therapy Assistant | Sage Meadow of Lake Geneva 6722 Wi-50, Lake Geneva, WI 53147 | 2020-01-28 |
| 1124539556 | Roxanne Weber | Registered Nurse | 146 E. Geneva Square, Lake Geneva, WI 53147 | 2017-10-12 |
| 1386969400 | Emily Kathleen Wilczak | Surgery | N2950 Wi-67, Lake Geneva, WI 53147 | 2010-03-31 |
| 1538294020 | Dale Alan Miller | Pharmacist | 2950 St. Hwy. 67, Lake Geneva, WI 53147 | 2007-02-23 |
| 1689779902 | Balistreri & Associates Physical Therapy | Physical Therapist | 902 Wells Street, Lake Geneva, WI 53147 | 2006-09-13 |
| 1336157981 | Nestor C Alabarca | Internal Medicine | 146 E Geneva Square, Lake Geneva, WI 53147 | 2006-08-03 |
| 1144259375 | Kim M. Cuculi | Occupational Therapist | 800 Geneva Pkwy N Ste 3, Lake Geneva, WI 53147 | 2006-07-01 |
| 1396253571 | Amar Y. Patel | Family Medicine | 146 E Geneva Sq, Lake Geneva, WI 53147 | 2018-01-22 |
| 1679017925 | Christina L. Clancy | Nurse Practitioner | 146 E Geneva Sq, Lake Geneva, WI 53147 | 2016-12-06 |
| Find all providers in zip 53147 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215414727 | Telemedico Physicians of Wisconsin Sc | Internal Medicine | 301 S Bedford St Ste 1, Madison, WI 53703-3691 | 2018-07-26 |
| 1649682667 | James King | Internal Medicine | 4540 S Sommerset Dr, New Berlin, WI 53151-6876 | 2014-05-26 |
| 1548686470 | Cullinane Cardiovascular Consultants, Sc | Internal Medicine | 317 N Lake Rd, Oconomowoc, WI 53066-7101 | 2014-03-17 |
| 1235492455 | David James Coulter | Internal Medicine | 2025 W Oklahoma Ave Ste 105, Milwaukee, WI 53215-4455 | 2012-06-21 |
| 1619234937 | Daniel R Harland | Internal Medicine | 2801 W Kinnickinnic River Pkwy Ste 880, Milwaukee, WI 53215-3678 | 2012-04-12 |
| 1295053106 | Setu D Trivedi | Internal Medicine | 10400 75th St Ste 212, Kenosha, WI 53142 | 2010-05-17 |
| 1336467554 | Expert Care Inc | Internal Medicine | 1111 E Sumner St, Suite A, Hartford, WI 53027-1609 | 2010-05-12 |
| 1548582547 | Moe Zafarani | Internal Medicine | 3215 W Lawrence St Ste 3, Appleton, WI 54914-4274 | 2010-02-18 |
| 1073844932 | James Harry Thomsen | Internal Medicine | 7709 Twinflower Dr, Madison, WI 53719-4544 | 2010-01-15 |
| 1740419019 | Thomas James Karras | Internal Medicine | 212 S Turtle Bay, Elkhart Lake, WI 53020-1985 | 2009-07-08 |
| Find all providers with the same taxonomy | ||||
| City | LAKE GENEVA |
| Zip Code | 53147 |
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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.