Individual provider Active NPI

Vijay K Kantamneni, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Madison, WI
National Provider Identifier
1316997406
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
28003-020 Issued in WI
Practice address
700 S Park St
Dean & St. Mary'S Outpatient Center
Madison, WI 53715-1830
Phone
(608) 260-2900
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 28003-020 WI Primary

Addresses

Primary practice location

700 S Park St
Dean & St. Mary'S Outpatient Center
Madison, WI 53715-1830

Mailing address

700 S Park St
Dean & St. Mary'S Outpatient Center
Madison, WI 53715-1830
Phone (608) 260-2900

Other practice location 1

1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6868

Other identifiers 3

IdentifierTypeStateIssuer
770000422OtherWIRAILROAD MEDICARE
31497100MedicaidWI
3564OtherWIDEAN HEALTH INSURANCE

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
I20100320000277 WI Practitioner - Cardiac SurgeryPractitioner - Thoracic SurgeryPractitioner - Vascular Surgery 4183759723 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: Thoracic Surgery, Vascular Surgery
Education
University of Wisconsin School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians

Practice addresses (Care Compare)

1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000

Hospital & facility affiliations

  • Mercy Health System Corp Hospital, Janesville, WI, CCN 520066
  • Mercy Walworth Hospital & Medical Center Hospital, Lake Geneva, WI, CCN 521357

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)20
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28003-020WIMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Oct 30, 2018 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee, Inc CurrentSince Dec 1, 2018 Accepting new patients
Columbia St. Mary'S Hospital Milwaukee Inc CurrentSince Dec 1, 2018 Accepting new patients
Mercy Health System Corporation Current Accepting new patients
Mercy Health System Corporation CurrentSince Dec 18, 2023 Accepting new patients
Mercy Health System Corporation CurrentSince Dec 18, 2023 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

19475 W North Ave
Ste 305
Brookfield, WI 53045
Phone (262) 780-4070

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

2350 N Lake Dr
Ste 400
Milwaukee, WI 53211
Phone (414) 270-1633

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

801 S 70th St
West Allis, WI 53214
Phone (414) 773-6600

Interoperability endpoints

  • Direct secure messaging: vkantamneni110344@direct.mhemail.org

Organizations & group practices 6

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 2

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1316997406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S PARK ST",
            "address_2": "DEAN & ST. MARY'S OUTPATIENT CENTER",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151830",
            "telephone_number": "608-260-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S PARK ST",
            "address_2": "DEAN & ST. MARY'S OUTPATIENT CENTER",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151830",
            "telephone_number": "608-260-2900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Mineral Point Ave",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535482940",
            "country_code": "US",
            "telephone_number": "608-756-6868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANTAMNENI",
        "first_name": "VIJAY",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WI",
            "license": "28003-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "770000422",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31497100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH INSURANCE",
            "identifier": "3564",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.