Madan N Kandula, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

44930-020 Issued in WI

Practice address

2885 N Mayfair Rd
Milwaukee, WI 53222-4404

Phone

(414) 771-6780

Fax

(414) 238-2424

NPI assigned

Oct 12, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI

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 1

Specialty

Otolaryngology

Education

Hahneman Medical College of the Pacific, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Ear Nose and Throat Specialists, SCGroup PAC ID 9335106319, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19820/brand/1/csg/1/fhir/r4

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

• Advanced Ear Nose & Throat Specialists, SC

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Milwaukee, WI
  • NPI 1689782427
  Medicare reassignment Care Compare group NPD Authorized official
• Advanced Ear Nose & Throat Specialists, SC

  • Otolaryngology Physician
  • Miamisburg, OH
  • NPI 1811717887
  NPD Authorized official
• Center for Sleep and Nasal Sinus Disorders, LLC

  • Otolaryngology Physician
  • Avon, IN
  • NPI 1235997800
  NPD Authorized official
• Center for Sleep and Nasal Sinus Disorders, LLC

  • Sleep Medicine (Otolaryngology) Physician
  • South Bend, IN
  • NPI 1568015485
  NPD Authorized official
• Ear Institutes, LLC

  • Otolaryngology Physician
  • Blaine, MN
  • NPI 1881168441
  NPD Authorized official
• Advanced Ear Nose & Throat Specialists, PLLC

  • Otolaryngology Physician
  • Vernon Hills, IL
  • NPI 1184281735
  NPD (past) Authorized official
• Affiliated ENT, SC

  • Medical Specialty Clinic/Center
  • Milwaukee, WI
  • NPI 1265544498
  NPD (past)

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1275521288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 W INNOVATION DR STE 200",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264851",
            "telephone_number": "414-771-6780",
            "fax_number": "414-238-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2885 N MAYFAIR RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532224404",
            "telephone_number": "414-771-6780",
            "fax_number": "414-238-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANDULA",
        "first_name": "MADAN",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "44930-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATION TAX ID",
            "identifier": "20-1759813",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34336200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Kanack, PTA
• Priyanka Kancherla, RPH
• Prem Kandiah, MD
• Cheryl Kandler-Krutina, RN
• Gwen M Kandula, AU.D, MBA
• Andrew W Kane, PH.D.
• Kristin Kane
• Richard S Kane, MD
• Crystal H Kang, MD
• Gina M Kangas, L.C.S.W.

• Otolaryngology Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Otolaryngology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; 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.