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PRADEEP GOPI KUMAR MD
NPI 1164463261
Pediatrics - Adolescent Medicine in Mount Pleasant, WI

Active since June 09, 2006PECOS Enrolled
8400 WASHINGTON AVE, MOUNT PLEASANT, WI 53406(262) 884-4000 Get Directions Write a Review

NPPES record last updated: November 6, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 6, 2023, Jan 6, 2022 (2 updates tracked since 2022).

About Pradeep Gopi Kumar Md NPPES

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

PRADEEP GOPI KUMAR MD (NPI 1164463261) is an individual adolescent medicine provider in Mount Pleasant, Wisconsin, licensed in Wisconsin (41877) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164463261
Entity TypeIndividualMale
Primary Taxonomy2080A0000X
Provider Legal NamePRADEEP GOPI KUMARCredential: MD
Location Address8400 WASHINGTON AVEMount Pleasant, WI 53406-3735
Mailing AddressPo Box 735044Chicago, IL 60673-5044
Phone(262) 884-4000
Sole ProprietorNo
Enumeration DateJune 9, 2006
Last NPPES UpdateNovember 6, 20232 updates tracked since enumeration
NPPES CertifiedNovember 6, 2023
✔ NPI 1164463261 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
License✔ Licensed in WI · 41877
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
8400 WASHINGTON AVE, Mount Pleasant, WI 53406
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Other Identifiers 1

Medicaid32632100WI

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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pradeep Gopi Kumar Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Pradeep Kumar reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Aurora Medical Group, Inc.
19 mi
Nurse Anesthetist, Certified Registered
3301 W FOREST HOME AVE
Milwaukee, WI 53215
  • Reassigned Medicare billing, Wisconsin enrollment
  • 4,609 clinicians in this Medicare group
NPI 1427271378 (877) 576-3544

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

MRS. NANDITA BATCHRA MD
Otolaryngology
8400 WASHINGTON AVE
MOUNT PLEASANT, WI 53406
Racine County (262) 884-4000
ALLISON MARIE BLONSKI MD
Pediatrics
8400 WASHINGTON AVE
MOUNT PLEASANT, WI 53406
Racine County (262) 884-4000
DR. REBECCA LINDSEY LESCHER M.D.
Pediatrics
8400 WASHINGTON AVE
MOUNT PLEASANT, WI 53406
Racine County (262) 884-4000
MS. PRIYA RAMDASS M.D
Family Medicine
8400 WASHINGTON AVE
MOUNT PLEASANT, WI 53406
Racine County (262) 321-3000
DR. MATTHEW ADAM PILECKI MD
Pain Medicine (Interventional Pain Medicine)
8400 WASHINGTON AVE
MOUNT PLEASANT, WI 53406
Racine County (262) 884-4000
AMY P KELLY DO
Family Medicine
8400 WASHINGTON AVE
MOUNT PLEASANT, WI 53406
Racine County (262) 321-3000
MICHAEL MULLANE MD
Medical Genetics (Clinical Genetics (M.D.))
8400 WASHINGTON AVE
MOUNT PLEASANT, WI 53406
Racine County (262) 884-8340
RACHEL R GAGE APN
Nurse Practitioner
8400 WASHINGTON AVE
MOUNT PLEASANT, WI 53406
Racine County (262) 321-3150

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 Pradeep Kumar's NPI number?

The NPI number for Pradeep Kumar is 1164463261. It was assigned to this individual provider in the NPPES registry on June 9, 2006.

Where is Pradeep Kumar located?

Pradeep Kumar practices at 8400 Washington Ave, Mount Pleasant, WI 53406. The listed phone number is (262) 884-4000.

What is Pradeep Kumar's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Is Pradeep Kumar enrolled in Medicare?

Yes. Pradeep Kumar is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Pradeep Kumar's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Pradeep Kumar reassigns Medicare benefits to Aurora Medical Group, Inc. (Milwaukee, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Pradeep Kumar's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Pradeep Kumar accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and Network Health and 2 other insurers list Pradeep Kumar 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.

When was this NPI record last updated?

The NPPES record for Pradeep Kumar was last updated on November 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.