Individual provider Active NPI

Prem Kandiah, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Milwaukee, WI
National Provider Identifier
1972684082
Registry record updated Aug 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
066191 Issued in GA
Practice address
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone
(414) 917-8531
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 48807 - 20 WI
Neurology Physician 2084N0400X 48807 - 20 WI
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 066191 GA Primary

Addresses

Primary practice location

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522

Mailing address

1920 North Farwell Ave
Unit 403
Milwaukee, WI 53202
Phone (973) 713-2446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20110726000746 GA Practitioner - Internal MedicinePractitioner - NeurologyPractitioner - Hospice/Palliative CarePractitioner - Critical Care (Intensivists) 9234307810 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospice/Palliative Care
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Emory Clinic IncGroup PAC ID 8820901408, 3,507 clinicians

Practice addresses (Care Compare)

1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525

2201 Henderson Mill Rd NE
Atlanta, GA 30345-2711

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
066191GAMDCritical Care Medicine (Internal Medicine) Physician
48807 - 20WIMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Emory Clinic Inc Internal Medicine CurrentSince Aug 1, 2011 Accepting new patients
Emory Medical Care Foundation Inc Internal Medicine CurrentSince Feb 18, 2025 Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Feb 18, 2025 Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

Interoperability endpoints

  • Direct secure messaging: pkandiah43523@direct.emory.org

Organizations & group practices 3

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 2

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503878400000",
    "number": "1972684082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 NORTH FARWELL AVE",
            "address_2": "UNIT 403",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53202",
            "telephone_number": "973-713-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-917-8531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANDIAH",
        "first_name": "PREM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2017-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "48807 - 20",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "48807 - 20",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "GA",
            "license": "066191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.