Pradeep Bangalore Prakash, MD

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

72580-20 Issued in WI

Practice address

835 S Van Buren St
Green Bay, WI 54301-3526

Phone

(920) 496-4700

NPI assigned

Feb 26, 2014

Last updated

Mar 21, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Pradeep B P Other name

Medicare fee-for-service enrollment

Enrolled in WI, IA, TX3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Prevea Clinic, Inc.

  • Internal Medicine Physician
  • Green Bay, WI
  • NPI 1306869276

  Pediatrics

  Medicare reassignment NPD
• St Vincent Hospital-Hospital Sisters-Third Order of St Francis

  dba Prevea Health

  • General Practice Physician
  • Green Bay, WI
  • NPI 1285613638

  Pediatrics

  Medicare reassignment NPD
• St. Nicholas Hospital-Sisters of the Third Order of St Francis

  dba Prevea Sheboygan Health Center

  • Internal Medicine Physician
  • Sheboygan, WI
  • NPI 1275799413
  Medicare reassignment NPD
• Emergency Medicine Services of TX, PLLC

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1245938729
  Medicare reassignment NPD
• Mercy Clinics, Inc.

  dba MercyOne Clive Family Medicine Clinic

  • Primary Care Clinic/Center
  • Clive, IA
  • NPI 1487670923
  Medicare reassignment NPD
• Prevea Clinic, Inc.

  • Family Medicine Physician
  • Chippewa Falls, WI
  • NPI 1588110969
  NPD
• St Nicholas Hospital-Sisters of the Third Order of St Francis

  dba St. Nicholas Hospital

  • Internal Medicine Physician
  • Sheboygan, WI
  • NPI 1447737762
  NPD
• St Vincent Hospital-Hospital Sisters-Third Order of St Francis

  dba Prevea Health

  • Durable Medical Equipment & Medical Supplies
  • Green Bay, WI
  • NPI 1245042530
  NPD
• St. Nicholas Hospital-Sisters of the Third Order of St Francis

  dba St Nicholas Hospital

  • General Acute Care Hospital
  • Sheboygan, WI
  • NPI 1730184342
  NPD
• Mercy Clinics, Inc

  dba MercyOne Des Moines Pediatric Hospitalists

  • Hospitalist Physician
  • Des Moines, IA
  • NPI 1881934750

  Pediatrics

  NPD
• Mercy Clinics, Inc.

  dba MercyOne Des Moines OB Hospitalists

  • Obstetrics & Gynecology Physician
  • Des Moines, IA
  • NPI 1508741505
  NPD
• St Vincent Hospital-Hospital Sisters-Third Order of St Francis

  dba St Vincent Hospital

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1114908001
  NPD (past)

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

{
    "created_epoch": "1393372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774051200000",
    "number": "1831514900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 S VAN BUREN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013526",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 S VAN BUREN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013526",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawkins Dr",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421009",
            "country_code": "US",
            "telephone_number": "319-353-8105",
            "fax_number": "319-356-4855",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 6th Ave",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503142611",
            "country_code": "US",
            "telephone_number": "515-247-3330",
            "fax_number": "515-643-8839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANGALORE PRAKASH",
        "first_name": "PRADEEP",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-26",
        "last_updated": "2026-03-21",
        "certification_date": "2026-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "72580-20",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "WV",
            "license": "35943",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "WI",
            "license": "72580-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PRADEEP",
            "last_name": "B P",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• James Joseph Balza, LCSW
• Kyla S Balzar, NP
• Denise M Balzola, MSW
• Stephanie Banaszynski, NP
• Lauren Louise Bancroft, FNP-C
• Dovile Baniulis, M.D.
• Edward John Bantamoi, MD
• Kasey Lynn Bantes-Behmke, PA-C
• Amanda Rose Bantle, APNP
• Bonnie Baranczyk, BSN, RN, NCSN

• Pediatric Critical Care Medicine Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Pediatric Critical Care Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2026; 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.