Khalid I Chaudhry, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

66397 Issued in WI

Practice address

459 E 1St St
Fond Du Lac, WI 54935-4505

Phone

(920) 929-3500

Fax

(920) 929-3129

NPI assigned

Sep 14, 2006

Last updated

Nov 5, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY, WI2 enrollments

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.

Enrollment records 2

Specialty

Psychiatry

Education

Other, 1991

Medicare assignment

May accept Medicare assignment

Group practices

SBH-Green Bay LLCGroup PAC ID 7517248198, 7 clinicians

Fond Du Lac CountyGroup PAC ID 2668376245, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fond Du Lac County

  dba Department of Human Services Clinical Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fond Du Lac, WI
  • NPI 1053458935
  Medicare reassignment Care Compare group NPD
• SBH-Green Bay LLC

  dba Willow Creek Behavioral Health

  • Psychiatric Hospital
  • Green Bay, WI
  • NPI 1922556778

  Psychiatry

  Medicare reassignment Care Compare group NPD
• SBH-Madison LLC

  • Psychiatric Hospital
  • Middleton, WI
  • NPI 1023884871
  Medicare reassignment NPD
• Mercy Medical Center

  • Internal Medicine Physician
  • Rockville Centre, NY
  • NPI 1619245610
  Medicare reassignment NPD
• Fond Du Lac County

  • Public Health or Welfare Agency
  • Fond Du Lac, WI
  • NPI 1285606178
  NPD
• SBH-Madison LLC

  dba Miramont Behavioral Health

  • Psychiatric Hospital
  • Middleton, WI
  • NPI 1003413816
  NPD (past)
• LMC Physician Services, PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1346256104

  Psychiatry

  NPD (past)
• Newyork-Presbyterian/Queens

  • Cardiovascular Disease Physician
  • Flushing, NY
  • NPI 1013960962

  Psychiatry

  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1104921766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 ONTARIO RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543118302",
            "telephone_number": "920-328-1220",
            "fax_number": "920-469-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 E 1ST ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354505",
            "telephone_number": "920-929-3500",
            "fax_number": "920-929-3129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N Village Ave",
            "address_2": "Suite 15",
            "address_purpose": "LOCATION",
            "city": "Rockville Centre",
            "state": "NY",
            "postal_code": "115703767",
            "country_code": "US",
            "telephone_number": "347-247-9172",
            "fax_number": "631-886-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAUDHRY",
        "first_name": "KHALID",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "66397",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "228976",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02460979",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100063716",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Central Wisconsin Radiation Oncology, S.C.
• Paul R Chambers, MD
• Christy Chang, APNP
• Henry T Chang, MD
• Jeremy A Chapman, MD
• Casey Chemer
• Edward J Chesna, M.D.
• John K Choi, MD
• Raymond Paul Chojnacki Jr., PHARMACIST
• Brenda J Christ-Gosein

• Psychiatry Physician in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.