Great Lakes Foot & Ankle Centers Inc
NPI 1295941409ActiveOrganization· Podiatrist, Foot & Ankle Surgery· Kenosha, WI
Podiatrist, Foot & Ankle Surgery in Kenosha, Wisconsin, registered in NPPES in May 2007. The authorized official on file is John L. Bostanche, DPM, Physician/Owner. Enrolled in Medicare as dme supplier - physician - podiatry and part b supplier - clinic/group practice.
Overview
| NPI | 1295941409 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 15, 2007 |
| Last updated in NPPES | Sep 20, 2021 |
| Certified by provider | Sep 20, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Podiatrist, Foot & Ankle Surgery Primary | 213ES0103X | 025 | WI |
| Podiatrist, Foot & Ankle Surgery | 213ES0103X | 016 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Physician - Podiatry (WI); Part B Supplier - Clinic/Group Practice (WI) |
|---|
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