Active NPI
Vijay K Kantamneni, MD
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Madison, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- 28003-020
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 770000422 | Other | WI | RAILROAD MEDICARE |
| 31497100 | Medicaid | WI | |
| 3564 | Other | WI | DEAN 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiac Surgery
- Education
- University of Wisconsin School of Medicine, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000
Hospital & facility affiliations
- Mercy Health System Corp
- Mercy Walworth Hospital & Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary artery bypass graft (CABG) | 20 |
| Varicose vein removal | 1-10 |
| Leg revascularization (restoring blood flow) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28003-020 | WI | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ascension Medical Group-Southeast Wisconsin Inc | Current | Accepting new patients | |
| Columbia St. Mary'S Hospital Milwaukee, Inc | Current | Accepting new patients | |
| Columbia St. Mary'S Hospital Milwaukee Inc | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | 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
- 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.
-
- Multi-Specialty Clinic/Center
- Janesville, WI
- NPI 1598718603
-
- Internal Medicine Physician
- Glendale, WI
- NPI 1609881077
-
- Multi-Specialty Clinic/Center
- Milwaukee, WI
- NPI 1023064482
-
- Psychiatric Hospital Unit
- Mequon, WI
- NPI 1417600909
-
- General Acute Care Hospital
- Janesville, WI
- NPI 1093768962
-
- Critical Access Hospital
- Lake Geneva, WI
- NPI 1699728550
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Janesville, WI
- NPI 1093768962
-
- Critical Access Hospital
- Lake Geneva, WI
- NPI 1699728550
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; 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.