Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Antonino Bommarito, PA-C

Individual provider Physician Assistant · NPI 1396416053

Antonino Bommarito, PA-C is a Physician Assistant in Green Bay, Wisconsin. Qualified in 2021, 5 years ago. Practices with St Vincent Hospital-Hospital Sisters-Third Order of St Francis, a 594-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
5
Licensed in
WI
In the registry since
2021
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1110 Kepler Dr
Green Bay, WI 54311-8306
Phone: (920) 288-5555
Fax: (920) 288-5550
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 2845 Greenbrier Rd, Green Bay, WI 54311-6519 — (920) 288-8000
  • 1500 Arbor Way, Kaukauna, WI 54130-7305 — (920) 288-5555
  • 3003 University Dr, Marinette, WI 54143-4110 — (715) 732-8200

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5614 (WI)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1396416053
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 22, 2021
Last updated in NPPESSeptember 26, 2024
Certification dateSeptember 26, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice St Vincent Hospital-Hospital Sisters-Third Order Of St Francis — 594 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations19 on file with Medicare

Other providers in Green Bay