Pradeep Bangalore Prakash, MD in Green Bay, WI

Pradeep Bangalore Prakash, MD is a medicare enrolled "Pediatrics - Pediatric Critical Care Medicine" physician in Green Bay, Wisconsin. His current practice location is 835 S Van Buren St, Green Bay, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (920) 496-4700.

Pradeep Bangalore Prakash is licensed to practice in Wisconsin (license number 72580-20) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1831514900.

Contact Information

	Pradeep Bangalore Prakash, MD
	835 S Van Buren St, Green Bay, WI 54301-3526
	(920) 496-4700
	Not Available

Map and Direction

Physician's Profile

Full Name	Pradeep Bangalore Prakash
Gender	Male
Speciality	Pediatrics - Pediatric Critical Care Medicine
Location	835 S Van Buren St, Green Bay, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1831514900
Provider Enumeration Date: 02/26/2014
Last Update Date: 02/21/2023

Medicare PECOS Information:

PECOS PAC ID: 7416225347
Enrollment ID: I20200601001905

Medical Identifiers

Medical identifiers for Pradeep Bangalore Prakash such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1831514900	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2080P0203X	Pediatrics - Pediatric Critical Care Medicine	MD-41570 (Iowa)	Secondary
208000000X	Pediatrics	MD-41570 (Iowa)	Secondary
2080P0203X	Pediatrics - Pediatric Critical Care Medicine	72580-20 (Wisconsin)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Pradeep Bangalore Prakash allows following entities to bill medicare on his behalf.

Entity Name	Prevea Clinic Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1306869276 PECOS PAC ID: 0042123150 Enrollment ID: O20031106000034

Entity Name	St. Nicholas Hospital-sisters Of The Third Order Of St Francis
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1275799413 PECOS PAC ID: 8325931652 Enrollment ID: O20040202001172

Entity Name	St Vincent Hospital-hospital Sisters-third Order Of St Francis
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285613638 PECOS PAC ID: 5799694675 Enrollment ID: O20080620000423

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Pradeep Bangalore Prakash is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Pradeep Bangalore Prakash, MD 835 S Van Buren St, Green Bay, WI 54301-3526 Ph: (920) 496-4700	Pradeep Bangalore Prakash, MD 835 S Van Buren St, Green Bay, WI 54301-3526 Ph: (920) 496-4700

Reviews and Comments

Pediatrics Doctors in Green Bay, WI

Mary Lynn Bartel, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 835 S Van Buren St, Room 1041, Green Bay, WI 54301 Phone: 920-496-4700 Fax: 920-496-4705
Kathleen Marie Barkow, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1821 S Webster Ave, Green Bay, WI 54301 Phone: 920-496-4700 Fax: 920-436-1319
Kristina Ann Houn, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2793 Lineville Rd, Green Bay, WI 54313 Phone: 920-496-4700
George E Whetmore, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 1821 S Webster Ave, Green Bay, WI 54301 Phone: 920-496-4700 Fax: 920-436-1319
Ralph Joseph Vardis, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 835 S Van Buren St, Green Bay, WI 54301 Phone: 920-496-4700 Fax: 920-433-8569
Dr. Robert Michael Rock Jr., MD Pediatrics Medicare: Medicare Enrolled Practice Location: 835 S. Vanburen St., Green Bay, WI 54301 Phone: 920-433-8360 Fax: 920-431-3163
James F Winston, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 835 S Van Buren St, Green Bay, WI 54301 Phone: 920-433-8360

Pradeep Bangalore Prakash, MD - Medicare Pediatrics in Green Bay, WI