Individual provider Active NPI

Nagarjun Rao, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Milwaukee, WI
National Provider Identifier
1275589293
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
42264-20 Issued in WI
Practice address
9200 W Wisconsin Ave
Department of Pathology
Milwaukee, WI 53226-3522
Phone
(414) 805-8442
Fax
(414) 805-8444
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 42264-20 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Department of Pathology
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Ave
Department of Pathology
Milwaukee, WI 53226-3522
Phone (414) 805-8442

Other identifiers 1

IdentifierTypeStateIssuer
1275589293MedicaidWI

Other names 1

  • Dr. Rayasam K Nagarjun Rao Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address nrao149682@direct.myadvocateaurora.org

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070405000067 WI Practitioner - Pathology 1759485485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Pathologists SCGroup PAC ID 7315850682, 55 clinicians

Practice addresses (Care Compare)

1032 E Sumner St
Aurora Medical Center Hartford
Hartford, WI 53027-1608
Phone (262) 670-7231

10400 75TH St
Kenosha, WI 53142-7884
Phone (262) 948-5690

13250 Washington Ave
Mount Pleasant, WI 53177-1516
Phone (262) 799-8001

252 McHenry St
Burlington, WI 53105-1828
Phone (414) 328-7950

2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone (920) 288-4747

2900 W Oklahoma Ave
Aurora St Luke'S Medical Center
Milwaukee, WI 53215-4330
Phone (414) 649-7338

3003 University Dr
Marinette, WI 54143-4110
Phone (715) 735-4200

3400 Union Ave
Sheboygan, WI 53081-8426
Phone (920) 802-1723

36500 Aurora Dr
Summit, WI 53066-4899
Phone (262) 434-5000

5000 Memorial Dr
Two Rivers, WI 54241-3900
Phone (920) 794-5288

725 American Ave
Waukesha, WI 53188-5031
Phone (262) 928-2287

855 N Westhaven Dr
Aurora Medical Center Oshkosh
Oshkosh, WI 54904-7668
Phone (920) 456-7500

8901 W Lincoln Ave
West Allis, WI 53227-2409

975 Port Washington Rd
Aurora Medical Center Grafton
Grafton, WI 53024-9201
Phone (262) 329-1000

W 3985 County Rd NN
Aurora Lakeland Medical Center
Elkhorn, WI 53121-4337
Phone (262) 741-2149

Hospital & facility affiliations

  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
  • Waukesha Memorial Hospital Hospital, Waukesha, WI, CCN 520008
  • West Allis Memorial Hospital Hospital, West Allis, WI, CCN 520139
  • Aurora Medical Center Kenosha Hospital, Kenosha, WI, CCN 520189
  • Aurora Medical Center Hospital, Grafton, WI, CCN 520207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
42264-20WIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
A2Cl Services, LLC Current Accepting new patients
Great Lakes Pathologists SC Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2015 Accepting new patients

Locations

252 McHenry St
Burlington, WI 53105
Phone (262) 763-2411

5900 S Lake Dr
Cudahy, WI 53110
Phone (414) 489-4055

W3985 Highway NN
Elkhorn, WI 53121
Phone (262) 741-2000

975 Port Washington Rd
Grafton, WI 53024
Phone (262) 329-1000

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

10400 75th St
Kenosha, WI 53142
Phone (262) 697-7000

3003 University Dr
Marinette, WI 54143
Phone (715) 735-4200

945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

13250 Washington Ave
Mount Pleasant, WI 53177
Phone (262) 799-8330

855 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 451-5643

36500 Aurora Dr
Summit, WI 53066
Phone (262) 434-1000

5000 Memorial Dr
Two Rivers, WI 54241
Phone (920) 794-5000

125 Hospital Dr
Watertown, WI 53098
Phone (920) 261-4210

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

8901 W Lincoln Ave
West Allis, WI 53227
Phone (414) 328-6000

Organizations & group practices 2

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1275589293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-8442",
            "fax_number": "414-805-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-8442",
            "fax_number": "414-805-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAO",
        "first_name": "NAGARJUN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WI",
            "license": "42264-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275589293",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "9200 W Wisconsin Ave",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532263522",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nrao149682@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "9200 W Wisconsin Ave",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532263522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "RAYASAM",
            "last_name": "NAGARJUN RAO",
            "middle_name": "K",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.