Eleazar M Kadile, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

20408 Issued in WI

Practice address

1538 Bellevue Street
Green Bay, WI 54311

Phone

(920) 468-9442

Fax

(920) 468-9714

NPI assigned

Jul 3, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 1999 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083812887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1538 BELLEVUE STREET",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54311",
            "telephone_number": "920-468-9442",
            "fax_number": "920-468-9714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1538 BELLEVUE STREET",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54311",
            "telephone_number": "920-468-9442",
            "fax_number": "920-468-9714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADILE",
        "first_name": "ELEAZAR",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WI",
            "license": "20408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reginald E Julien, M.D.
• Stephanie Julius
• Susan L Jungen
• Kayla Marie Juntunen, DPT
• Melanie Anne Juron, RN
• Venkata Ravi Kiran Kadipi Reddy, M.D.
• Molly Terese Kadlec, MD
• Katie M Kadonsky, LPC
• Jennifer Lynn Kahler, MS CCC-SLP
• Jace Iokepa Kaikuaana, PT

• General Practice Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• General Practice Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.