NPIMap

Individual provider Active NPI

Chaitanya Pant, M.D.

  • Gastroenterology Physician
  • Green Bay, WI
National Provider Identifier
1639389984
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
67374-020 Issued in WI
Practice address
1726 Shawano Ave
Green Bay, WI 54303-3216
Phone
(920) 496-4700
NPI assigned
May 23, 2007
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 04-36304 KS
Gastroenterology Physician 207RG0100X 67374-020 WI Primary

Addresses

Primary practice location

1726 Shawano Ave
Green Bay, WI 54303-3216

Mailing address

Prevea Health
PO Box 19070
Green Bay, WI 54307-9070
Phone (920) 496-4700

Other practice location 1

Kansas University Medical Center 3901 Blvd
Department of Gastroenterology
Kansas City, KS 66160-0001
Phone (913) 588-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170719003385 WI Practitioner - Gastroenterology 8426354838 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1726 Shawano Ave
Green Bay, WI 54303-3216
Phone (920) 496-4700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy87
Upper gastrointestinal (GI) endoscopy for acid reflux508

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67374-020WIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Clare Memorial Hospital, Inc. CurrentSince Feb 1, 2019 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Jul 10, 2017 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Gastroenterology CurrentSince Jul 10, 2017 Accepting new patients
St Clare Memorial Hospital, Inc CurrentSince Feb 1, 2019 Accepting new patients

Locations

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

1860 Shawano Ave
Green Bay, WI 54303
Phone (920) 405-1414

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

835 S Main St
Oconto Falls, WI 54154
Phone (920) 846-0509

855 S Main St
Ste 1
Oconto Falls, WI 54154
Phone (920) 846-8187

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1639389984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PREVEA HEALTH",
            "address_2": "PO BOX 19070",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079070",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 SHAWANO AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033216",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Kansas University Medical Center 3901 Blvd",
            "address_2": "Department of Gastroenterology",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "KS",
            "postal_code": "661600001",
            "country_code": "US",
            "telephone_number": "913-588-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANT",
        "first_name": "CHAITANYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "KS",
            "license": "04-36304",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WI",
            "license": "67374-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.