PRADEEP BANGALORE PRAKASH


Address: 835 S Van Buren St, Green Bay, WI 54301-3526
Phone: 9204964700

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).

Provider Overview

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

Taxonomy

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

Provider Secondary Practice Location

Address Telephone Number Fax Number
1111 6th Ave, Des Moines, IA 503142611 5152473330
200 Hawkins Dr, Iowa City, IA 522421009 3193538105 3193564855

Office Location

Street Address 835 S VAN BUREN ST
City GREEN BAY
State WI
Zip Code 54301-3526

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 2080P0203X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Pediatric Critical Care Medicine

Taxonomy Definition

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)

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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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Competitor

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City GREEN BAY
Zip Code 54301

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Dataset Information

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.

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