Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Jacqueline Lee Bogan, DO

Individual provider Anesthesiology Physician · NPI 1073856761

Jacqueline Lee Bogan, DO practises Anesthesiology in Fond Du Lac, Wisconsin. Graduated from New York College of Osteo Medicine of New York Institute of Technology in 2013, 13 years ago. Practices with Agnesian Healthcare Inc, a 390-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
13
Trained at
New York College of Osteo Medicine of New York Institute of Technology
Licensed in
WI
In the registry since
2013
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

430 E Division St
Fond Du Lac, WI 54935-4560
Phone: (920) 929-2300
Fax: (608) 262-6247
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 67077 (WI)

Record details

NPI number1073856761
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 1, 2013
Last updated in NPPESNovember 2, 2020
Certification dateNovember 2, 2020

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY
Medical schoolNEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
Graduated 2013 (13 years in practice)
Group practice Agnesian Healthcare Inc — 390 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients153
Services billed 165 a service is one billed item, such as a visit, a test or a procedure
Average patient age75

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

  • Ssm Health St Agnes Hospital-Fond Du Lac Hospital · Fond Du Lac, WI

Colleagues at Agnesian Healthcare Inc

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 390 clinicians in the practice; 12 are shown here.

Other providers in Fond Du Lac