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DR. PRERNA RAJ PANDYA M.D.
NPI 1063754125
Obstetrics & Gynecology - Urogynecology and Reconstructive Pelvic Surgery in Milwaukee, WI

Active since March 26, 2013PECOS EnrolledAccepts Medicare Assignment
9200 W WISCONSIN AVENUE, UROGYNECOLOGY, MILWAUKEE, WI 53226(414) 805-3666(414) 805-6622 Get Directions Write a Review

NPPES record last updated: November 30, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 13, 2023, Nov 29, 2021, Jul 25, 2017 (3 updates tracked since 2017).

About Dr. Prerna Raj Pandya M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PRERNA RAJ PANDYA M.D. (NPI 1063754125) is an individual urogynecology and reconstructive pelvic surgery provider in Milwaukee, Wisconsin, licensed in Wisconsin (72958) and active in the NPI registry since March 2013. She is enrolled in Medicare PECOS, is affiliated with St Josephs Community Hospital West Bend, and maintains a secondary practice location in West Bend.

NPPES Registry Identity

NPI1063754125
Entity TypeIndividualFemale
Primary Taxonomy207VF0040X
Provider Legal NameDR. PRERNA RAJ PANDYACredential: M.D.
Location Address9200 W WISCONSIN AVENUE, UROGYNECOLOGYMilwaukee, WI 53226-3522
Mailing Address9200 W Wisconsin Avenue, UrogynecologyMilwaukee, WI 53226-3522 · (414) 805-3666 · Fax (414) 805-6622
Phone(414) 805-3666
Fax(414) 805-6622
Sole ProprietorNo
Medical School CMSIndiana University School Of MedicineGraduated 2013
Enumeration DateMarch 26, 2013
Last NPPES UpdateNovember 30, 20233 updates tracked since enumeration
NPPES CertifiedNovember 30, 2023
✔ NPI 1063754125 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · Urogynecology and Reconstructive Pelvic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207VF0040X
License✔ Licensed in WI · 72958
Definition

A subspecialist in Urogynecology and Reconstructive Pelvic Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them.

9200 W WISCONSIN AVENUE, Milwaukee, WI 53226
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Other Names 1

Former Name (1)Prerna Raj Md

Secondary Practice Location 1

Location 13200 Pleasant Valley RdWest Bend, WI 53095-9274 · Phone (262) 836-7300 · Fax (262) 836-7301

Other Identifiers 1

Medicaid1063754125WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Prerna Raj Pandya M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9234430059
PECOS Enrollment IDI20200730003645
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
43 services41 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
41 services36 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
20 services17 patients
Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings 51784
This procedure involves the use of non-invasive devices to record the electrical activity of muscles at specific body openings. It's helpful in understanding muscle function and can assist in diagnosing certain conditions.
18 services17 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
18 services18 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
18 services16 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Josephs Community Hospital West Bend

Acute Care Hospitals · West Bend, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520063
Location3200 Pleasant Valley RoadWest Bend, WI 53095 · Washington County
Emergency services Birthing friendly

Froedtert Memorial Lutheran Hospital

Acute Care Hospitals · Milwaukee, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520177
Location9200 W Wisconsin AveMilwaukee, WI 53226 · Milwaukee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53226 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MARK WALTER BOSBOUS
Plastic Surgery
9200 W WISCONSIN AVENUE, PLASTIC SURGERY
MILWAUKEE, WI 53226
Milwaukee County (414) 805-3666
DR. BRIAN ROBERTSON-DICK MD
Physical Medicine & Rehabilitation
9200 W WISCONSIN AVENUE, PHYSICAL MEDICINE AND REHABILITATION
MILWAUKEE, WI 53226
Milwaukee County (414) 805-7342
SUPATRA A AGARWAL AA
Anesthesiologist Assistant
9200 W WISCONSIN AVENUE, DEPARTMENT OF ANESTHESIOLOGY
MILWAUKEE, WI 53226
Milwaukee County (414) 805-8700
PROF. KONDRAGUNTA RAJENDRA PRASAD MD
Transplant Surgery
9200 W WISCONSIN AVENUE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-6400
SHERVIN MIRSHAHI M.D.
Radiology (Diagnostic Radiology)
9200 W WISCONSIN AVENUE, DEPARTMENT OF RADIOLOGY
MILWAUKEE, WI 53226
Milwaukee County (414) 805-2060
JING QI MD
Radiology (Diagnostic Radiology)
9200 W WISCONSIN AVENUE, DEPARTMENT OF RADIOLOGY
MILWAUKEE, WI 53226
Milwaukee County (414) 805-2060
MR. BRIAN G CARLSON MSN
Nurse Practitioner (Acute Care)
9200 W WISCONSIN AVENUE, DEPARTMENT OF RADIOLOGY
MILWAUKEE, WI 53226
Milwaukee County (414) 805-3750
GOKULAKRISHNAN BALASUBRAMANIAN M.D.
Internal Medicine (Gastroenterology)
9200 W WISCONSIN AVENUE, DIVISION OF GASTROENTEROLOGY
MILWAUKEE, WI 53226
Milwaukee County (414) 805-3310

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prerna Pandya's NPI number?

The NPI number for Prerna Pandya is 1063754125. It was assigned to this individual provider in the NPPES registry on March 26, 2013. The provider is also known as Prerna Raj MD.

Where is Prerna Pandya located?

Prerna Pandya practices at 9200 W Wisconsin Avenue Urogynecology, Milwaukee, WI 53226. The listed phone number is (414) 805-3666.

What is Prerna Pandya's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Urogynecology and Reconstructive Pelvic Surgery, with taxonomy code 207VF0040X.

Is Prerna Pandya enrolled in Medicare?

Yes. Prerna Pandya is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Prerna Pandya accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and Network Health list Prerna Pandya as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Prerna Pandya affiliated with any hospitals?

According to CMS data, Prerna Pandya is affiliated with St Josephs Community Hospital West Bend and Froedtert Memorial Lutheran Hospital.

When was this NPI record last updated?

The NPPES record for Prerna Pandya was last updated on November 30, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.