Individual provider Active NPI

Girija G Konduri, MD

  • Neonatal-Perinatal Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1407808223
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
42144 Issued in WI
Practice address
9000 W Wisconsin Ave
Division of Neonatology
Milwaukee, WI 53226-4874
Phone
(414) 266-6452
Fax
(414) 266-6979
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 42144 WI Primary

Addresses

Primary practice location

9000 W Wisconsin Ave
Division of Neonatology
Milwaukee, WI 53226-4874

Mailing address

9000 W Wisconsin Ave
Division of Neonatology
Milwaukee, WI 53226-4874
Phone (414) 266-6452

Other practice location 1

W180N8085 Town Hall Rd
Menomonee Falls, WI 53051-3518
Phone (262) 257-5000

Other practice location 2

3200 Pleasant Valley Rd
West Bend, WI 53095-9274
Phone (262) 836-7300

Other practice location 3

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-6600

Other identifiers 3

IdentifierTypeStateIssuer
008000315BOtherHUMANA
32639600MedicaidWI
1407808223MedicaidWI

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
I20040126000531 WI Practitioner - Pediatric Medicine 6305748625 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
42144WIMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. CurrentSince Mar 21, 2011 Accepting new patients

Locations

W180N8085 Town Hall Rd
Menomonee Fls, WI 53051
Phone (262) 257-5000

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

9000 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 266-2625

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

3200 Pleasant Valley Rd
West Bend, WI 53095
Phone (262) 334-5533

Interoperability endpoints

  • Direct secure messaging: gkonduri6117@direct.chw.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1407808223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "DIVISION OF NEONATOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-6452",
            "fax_number": "414-266-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "DIVISION OF NEONATOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-6452",
            "fax_number": "414-266-6979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "W180N8085 Town Hall Rd",
            "address_purpose": "LOCATION",
            "city": "Menomonee Falls",
            "state": "WI",
            "postal_code": "530513518",
            "country_code": "US",
            "telephone_number": "262-257-5000",
            "fax_number": "262-518-5052",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 Pleasant Valley Rd",
            "address_purpose": "LOCATION",
            "city": "West Bend",
            "state": "WI",
            "postal_code": "530959274",
            "country_code": "US",
            "telephone_number": "262-836-7300",
            "fax_number": "262-836-7301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-805-6600",
            "fax_number": "414-805-6622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONDURI",
        "first_name": "GIRIJA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "WI",
            "license": "42144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "008000315B",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32639600",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407808223",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.