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

Jeffrey M Bastasic, MD

Individual provider Family Medicine Physician · NPI 1164547600

Jeffrey M Bastasic, MD is a Family Practice in Menasha, Wisconsin. Graduated from Medical College of Wisconsin in 2007, 19 years ago. Practices with Ascension Medical Group-Fox Valley Wisconsin, Inc, a 260-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
19
Trained at
Medical College of Wisconsin
Licensed in
WI
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

878 W Airport Rd
Menasha, WI 54952-1461
Phone: (920) 727-5982
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 52366 (WI)

Record details

NPI number1164547600
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 21, 2007
Last updated in NPPESJanuary 6, 2021
Certification dateJanuary 6, 2021
Mailing address878 W Airport Rd, Menasha, WI 54952-1461

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 2007 (19 years in practice)
Group practice Ascension Medical Group-Fox Valley Wisconsin, Inc — 260 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations10 on file with Medicare

Other providers in Menasha