PRADEEP BANGALORE PRAKASH (NPI# 1831514900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831514900 |
| Entity Type | Individual |
| Full Name | PRADEEP BANGALORE PRAKASH |
| Other Name | PRADEEP B P |
| Credential | MD |
| Practice Address |
835 S Van Buren St Green Bay WI 54301-3526 |
| Practice Telephone | 9204964700 |
| Mailing Telephone | 9204964700 |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2020-05-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | MD-41570 | IA | Allopathic & Osteopathic Physicians |
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
MD-41570 | IA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1111 6th Ave, Des Moines, IA 503142611 | 5152473330 | |
| 200 Hawkins Dr, Iowa City, IA 522421009 | 3193538105 | 3193564855 |
| Street Address |
835 S VAN BUREN ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-3526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093707689 | Louis A Suarez | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2005-08-18 |
| 1114526530 | Keisha Vickman | Nurse Practitioner | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2020-10-19 |
| 1902416480 | Tyler William Shimek | Nurse Anesthetist, Certified Registered | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2020-08-09 |
| 1770100489 | Fuad Emile Zankoul | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2020-06-29 |
| 1942822473 | Brittany Elizabeth Pitsch | Nurse Anesthetist, Certified Registered | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2020-05-06 |
| 1669093175 | Lacey Renee Anderson | Student in an Organized Health Care Education/Training Program | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2020-05-06 |
| 1891320834 | Tarra Lynn Moran | Hospitalist | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2020-03-10 |
| 1780219238 | Shea A Sternhagen | Nurse Practitioner | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2020-03-05 |
| 1508490780 | Christopher Michael Robinson | Anesthesiology | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2020-02-26 |
| 1083250872 | Brandyn Robert Behnke | Registered Nurse | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2019-11-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| Find all providers in zip 54301 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841253077 | John W Taylor | Pediatrics | Prevea Health, 835 S. Van Buren Street, Green Bay, WI 54301 | 2006-04-10 |
| 1053607689 | Muhammad Ali Syed | Pediatrics | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2011-06-22 |
| 1073548616 | Ralph Joseph Vardis | Pediatrics | 835 S Van Buren St, Green Bay, WI 54301-3526 | 2006-07-12 |
| 1861425456 | Joel Steven Ament | Pediatrics | 835 S Van Buren St, Room 1041, Green Bay, WI 54301-3526 | 2006-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083675979 | Michael Thomas Meyer | Pediatrics | 9000 W Wisconsin Ave # 681, Milwaukee, WI 53226-4874 | 2006-03-30 |
| 1235512104 | Megan Williams | Pediatrics | 600 Highland Ave, Madison, WI 53792 | 2015-07-09 |
| 1528324019 | Lindsey Nye Troy | Pediatrics | 8701 W Watertown Plank Rd, Milwaukee, WI 53226 | 2012-04-09 |
| 1669768008 | Nita Davis | Pediatrics | 9000 W Wisconsin Avenue, Pediatric Critical Care, Milwaukee, WI 53226-4874 | 2011-06-23 |
| 1689968430 | Shaista Shaik | Pediatrics | 1836 South Ave, La Crosse, WI 54601-5429 | 2011-06-08 |
| 1366734501 | Adam O Szadkowski | Pediatrics | 9000 W Wisconsin Ave, Milwaukee, WI 53226 | 2011-05-06 |
| 1861711632 | Mohammed Abdulaziz Hamzah | Pediatrics | 9000 W Wisconsin Ave, Pediatric Critical Care, Milwaukee, WI 53226-4874 | 2010-05-19 |
| 1093945800 | Megan E Peters | Pediatrics | Uw Hospital and Clinics, 600 Highland Ave, Madison, WI 53792-0001 | 2009-07-15 |
| 1215165477 | Awni M Al-subu | Pediatrics | 600 Highland Ave, Madison, WI 53792-0001 | 2009-06-26 |
| 1457594970 | Juan P Boriosi | Pediatrics | 600 Highland Ave., Madison, WI 53792-3284 | 2009-04-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.