JACQUELINE KALIS BOHANKO (PA-C) – Medical Physician Assistant, NPI 1760631279

JACQUELINE KALIS BOHANKO (PA-C) is a healthcare provider. based in Harleysville, Pennsylvania. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 25MP00879200 (NJ). The NPI Number for JACQUELINE KALIS BOHANKO (PA-C) is 1760631279

Main info

Female
18 Years Of Experience
Accepts Medicare Assignment
Name
JACQUELINE KALIS BOHANKO (PA-C)
NPI
1760631279
Phone
(215) 453-4995
Address
PO BOX 1111
Enumeration Date
9 September 2008
Last Update Date
17 September 2024

Doctor Profile

Medical School Name
DREXEL UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
6099268899
Graduation Year
2008 (18 years ago)
PAC ID
2961556345
Group Practice PAC ID
6002229473
Professional Enrollment ID
I20090819000738
Address ID
PA191253006PH2418XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness75
Years active:17State licenses:2Digital endpointsOther names

9,691 PHYSICIAN ASSISTANT in PA

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Provider Addresses for JACQUELINE KALIS BOHANKO (PA-C)

  • PO BOX 1111

    HARLEYSVILLE, PA 194380907

    Phone: (215) 453-4995

    Fax: (215) 453-4646

    Type: Mailing

  • 2099 NEW ALBANY RD

    CINNAMINSON, NJ 080773534

    Phone: (609) 926-8899

    Fax: (856) 772-1997

    Type: Mailing

  • Grand View Health, 700, Lawn Avenue, Sellersville, Bucks County, Pennsylvania, 18960, United States

    SELLERSVILLE, PA 189601548

    Phone: (215) 453-4139

    Fax: (215) 453-4991

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $13.

Total Amount is formed as General ($13) + Research ($0) + Ownership ($0) = $13.

Last reported payment date: 2024-11-26 • Largest payer in this snapshot: ABBVIE INC. ($13).

Total Amount

$13

General + Research + Ownership

Payments

1

Total payment records

General Amount

$13

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-26

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$13
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-10-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090819000738IPhysician AssistantPATBD
I20241024002239IPhysician AssistantNJTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 19438)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002229473View full group profile
NameSpecialtyState
Nurse PractitionerNJ
Physician AssistantPA
Nurse PractitionerPA
Physician AssistantPA
Nurse PractitionerPA
Physician AssistantNJ

Reviews

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Frequently asked questions

What number should I use to identify JACQUELINE KALIS BOHANKO (PA-C) for billing?
Administrative and clinical systems typically use NPI 1760631279 for JACQUELINE KALIS BOHANKO (PA-C).
Should I treat JACQUELINE KALIS BOHANKO (PA-C) as an active provider?
Patients and plans typically see JACQUELINE KALIS BOHANKO (PA-C) as active in the national extract.
How should patients interpret JACQUELINE KALIS BOHANKO (PA-C)'s specialty?
The extract shows Medical Physician Assistant for JACQUELINE KALIS BOHANKO (PA-C). Clinical services aligned with this taxonomy classification.
What city is tied to JACQUELINE KALIS BOHANKO (PA-C)?
The directory associates JACQUELINE KALIS BOHANKO (PA-C) with Harleysville, Pennsylvania. Check all listed addresses for suites or satellite offices.
Why is information missing for JACQUELINE KALIS BOHANKO (PA-C)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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