Individual provider Active NPI

Kumari S Chintamaneni, MD

  • Internal Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1790740850
Registry record updated Aug 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
28498 Issued in WI
Practice address
3267 So 16TH St
Suite 103
Milwaukee, WI 53215-4500
Phone
(414) 671-1449
Fax
(414) 671-0161
NPI assigned
Apr 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 28498 WI Primary

Addresses

Primary practice location

3267 So 16TH St
Suite 103
Milwaukee, WI 53215-4500

Mailing address

3267 So 16TH St
Suite 103
Milwaukee, WI 53215-4500
Phone (414) 671-1449

Other identifiers 1

IdentifierTypeStateIssuer
31560200MedicaidWI

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
I20081113000540 WI Practitioner - Internal MedicinePractitioner - Geriatric Medicine 2961408166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension Medical Group-Southeast Wisconsin IncGroup PAC ID 8628980943, 551 clinicians

Practice addresses (Care Compare)

3267 S 16TH St
Suite 200
Milwaukee, WI 53215-4500
Phone (414) 647-5069

Hospital & facility affiliations

  • Ascension at Home Home health agency, Milwaukee, WI, CCN 527187
  • Ascension St Francis Hospital Hospital, Milwaukee, WI, CCN 520078
  • Ascension SE Wisconsin Hospital Hospital, Milwaukee, WI, CCN 520136
  • Ascension Columbia St Marys Hospital Milwaukee Hospital, Milwaukee, WI, CCN 520051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28498WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc Internal Medicine CurrentSince Mar 5, 2008 Accepting new patients

Locations

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

3267 S 16th St
Ste 103
Milwaukee, WI 53215
Phone (414) 671-1449

3267 S 16th St
Ste 200
Milwaukee, WI 53215
Phone (414) 389-3111

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

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.

Hospital & facility affiliations 5

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312156800000",
    "number": "1790740850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3267 SO 16TH ST",
            "address_2": "SUITE 103",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154500",
            "telephone_number": "414-671-1449",
            "fax_number": "414-671-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3267 SO 16TH ST",
            "address_2": "SUITE 103",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532154500",
            "telephone_number": "414-671-1449",
            "fax_number": "414-671-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHINTAMANENI",
        "first_name": "KUMARI",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2011-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "28498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31560200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.