Ganesh N Pulla
SURYA MEDICAL GROUP SC


Address: 6125 Green Bay Rd, Suite 100, Kenosha, WI 53142-2942
Phone: 2625648636

Ganesh N Pulla (NPI# 1679620918, PAC ID# 0345218384) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEPHROLOGY.

Physician Overview

Nation Provider ID (NPI) 1679620918
PAC ID by PECOS 0345218384
Professional Enrollment ID I20040920000113
Full Name Ganesh N Pulla
Organization Legal Name SURYA MEDICAL GROUP SC
Address 6125 Green Bay Rd
Suite 100
Kenosha
WI 53142-2942
Phone Number 2625648636
Gender M
Credential MD
Graduation Year 1982
Primary Specialty NEPHROLOGY
Secondary Specialties INTERNAL MEDICINE
Group Practice PAC ID 5991773939
Number of Group Practice Members 2
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
520021 UNITED HOSPITAL SYSTEM
520189 AURORA MEDICAL CENTER KENOSHA

Other Locations

Address Phone Organization
6125 Green Bay Rd, Suite 100, Kenosha, WI 53142-2942 2625648636 SURYA MEDICAL GROUP SC
1025 Red Oak Ln, Suite 280, Lindenhurst, IL 60046-5023 8472954747 SURYA MEDICAL GROUP SC

Organization Information

Organization Legal Name SURYA MEDICAL GROUP SC
Physicians 2

Physicians with the same organization

Name Specialty Organization Address
Bharathi Pulla Family Medicine Surya Medical Group Sc 6125 Green Bay Rd, Suite 100, Kenosha, WI 53142-2942

Office Location

Street Address 6125 GREEN BAY RD
SUITE 100
City KENOSHA
State WI
Zip 53142-2942

Physicians in the same location

Name Specialty Organization Address
Pushparanee Babusukumar Psychiatry Psychiatric and Psychotherapy Clinic L I Newman Md Sc Gen Ptr 6125 Green Bay Rd, Suite 700, Kenosha, WI 53142-2928
Tom A Defrancesco Clinical Social Worker Psychiatric and Psychotherapy Clinic L I Newman Md Sc Gen Ptr 6125 Green Bay Rd, Suite 700, Kenosha, WI 53142-2928
Donna J Hayes Podiatry 6125 Green Bay Rd, Suite 600, Kenosha, WI 53142-2928
Corrie R Lee Clinical Social Worker Psychiatric and Psychotherapy Clinic L I Newman Md Sc Gen Ptr 6125 Green Bay Rd, Suite 700, Kenosha, WI 53142-2928
Lisa M Defazio Clinical Social Worker Psychiatric and Psychotherapy Clinic L I Newman Md Sc Gen Ptr 6125 Green Bay Rd, Suite 700, Kenosha, WI 53142-2928
Mary Girsh-jensen Clinical Social Worker Psychiatric and Psychotherapy Clinic L I Newman Md Sc Gen Ptr 6125 Green Bay Rd, Suite 700, Kenosha, WI 53142-2928
Sharee Lanee Chance-lawson Family Medicine Independent Physicians of Wisconsin LLC 6125 Green Bay Rd, Suite 600, Kenosha, WI 53142-2928
Victor S Slana Ophthalmology 6125 Green Bay Rd, Suite 800, Kenosha, WI 53142-2982
Ashokkumar K Shah Psychiatry Psychiatric and Psychotherapy Clinic L I Newman Md Sc Gen Ptr 6125 Green Bay Rd, Suite 700, Kenosha, WI 53142-2928
Paul M Defazio Clinical Social Worker Psychiatric and Psychotherapy Clinic L I Newman Md Sc Gen Ptr 6125 Green Bay Rd, Suite 700, Kenosha, WI 53142-2928
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Physicians in the same zip code

Name Specialty Organization Address
Randall J Hammett Chiropractic 6500 67th St, Kenosha, WI 53142-1403
Laurie Sasso Clinical Social Worker Wellqor Psychological Services of Wisconsin, S.c. 6300 67th St, Kenosha, WI 53142-1437
Rodrigo B Mata Iii Internal Medicine 6123 Green Bay Rd, Suite 120, Kenosha, WI 53142-2927
Nancy Guadagno Clinical Social Worker 6123 Green Bay Rd, Suite 240, Kenosha, WI 53142-2927
Shellie Kaye Babcock Clinical Social Worker 6123 Green Bay Rd, Suite 240, Kenosha, WI 53142-2927
Chad E Sloden Chiropractic Sports and Family Chiropractic LLC 6123 Green Bay Rd, Suite 140, Kenosha, WI 53142-2927
Nicholas Joseph Hollendonner Chiropractic Sports and Family Chiropractic LLC 6123 Green Bay Rd, Suite 140, Kenosha, WI 53142-2927
Jessica Rummel Busch Clinical Social Worker Psychiatric and Psychotherapy Clinic L I Newman Md Sc Gen Ptr 6125 Green Bay Rd, Suite 700, Kenosha, WI 53142-2928
Jennifer R Sarafin Clinical Social Worker Fleming Psychological Services Sc 6121 Green Bay Rd, Suite 230, Kenosha, WI 53142-2929
Ann M Fleming Clinical Social Worker Fleming Psychological Services Sc 6121 Green Bay Rd, Suite 230, Kenosha, WI 53142-2929
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Competitor

Search similar physicians

City KENOSHA
Zip Code 53142
Specialty NEPHROLOGY
City + Specialty KENOSHA + NEPHROLOGY

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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