Kathryn Gradecki

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

66257-20 Issued in WI

Practice address

13950 W Capitol Dr Ste 200
Brookfield, WI 53005

Phone

(262) 781-3065

Fax

(262) 781-3835

NPI assigned

Apr 6, 2015

Sex

Female

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 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kgradecki38953@direct.chw.org

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.

• Children'S Medical Group

  • Pediatrics Physician
  • Glendale, WI
  • NPI 1134394471
  NPD (past)
• Childrens Hospital of Wisconsin, Inc.

  • Pediatrics Physician
  • Milwaukee, WI
  • NPI 1245308626
  NPD (past)

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1447645452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE # MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-7615",
            "fax_number": "414-266-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13950 W CAPITOL DR STE 200",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "53005",
            "telephone_number": "262-781-3065",
            "fax_number": "262-781-3835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADECKI",
        "first_name": "KATHRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-06",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "66257-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447645452",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Gooding
• Gorecki Psychological Services LLC
• Kim Marie Gorecki, PSYD
• Michael P Goss, MD
• Khushi Goyal
• Eva Graham
• Jessica L Grams, DDS
• Natalie Grandahl, MOT
• Elliot Grant
• Jacob Gravenkamp

• Pediatrics Physician in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Pediatrics Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.