Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacqueline Kalis Bohanko, PA-C

Individual provider Physician Assistant · NPI 1760631279

Jacqueline Kalis Bohanko, PA-C is a Physician Assistant in Cinnaminson, New Jersey. Graduated from Drexel University College of Medicine in 2008, 18 years ago. Practices with Coyle S Connolly DO PA, a 32-clinician group and accepts Medicare assignment. Licensed in New Jersey and Pennsylvania.

Years since qualifying
18
Trained at
Drexel University College of Medicine
Licensed in
NJ, PA
In the registry since
2008
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

2099 New Albany Rd
Cinnaminson, NJ 08077-3534
Phone: (099) 268-8996
Fax: (856) 772-1997
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence MA053571 (PA)
Physician Assistant Taxonomy 363A00000X · Licence 25MP00879200 (NJ)

Record details

NPI number1760631279
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 9, 2008
Last updated in NPPESSeptember 17, 2024
Certification dateSeptember 17, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolDREXEL UNIVERSITY COLLEGE OF MEDICINE
Graduated 2008 (18 years in practice)
Group practice Coyle S Connolly Do Pa — 32 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Cinnaminson