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DR. JAMES DANIEL PRAHL M.D.
NPI 1437211539
Internal Medicine - Critical Care Medicine in Milwaukee, WI

Active since December 14, 2006PECOS EnrolledAccepts Medicare Assignment
2900 WEST OKLAHOMA AVE, 2ND FLOOR GALLERIA, MILWAUKEE, WI 53215(414) 649-6572(414) 649-5815 Get Directions Write a Review

NPPES record last updated: December 1, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 1, 2021, Dec 9, 2020, Jul 5, 2019 (3 updates tracked since 2019).

About Dr. James Daniel Prahl M.d. NPPES

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

DR. JAMES DANIEL PRAHL M.D. (NPI 1437211539) is an individual critical care medicine provider in Milwaukee, Wisconsin, licensed in Wisconsin (49725-020) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS, is affiliated with Aurora St Lukes Medical Center, and maintains a secondary practice location in Milwaukee.

NPPES Registry Identity

NPI1437211539
Entity TypeIndividualMale
Primary Taxonomy207RC0200X
Provider Legal NameDR. JAMES DANIEL PRAHLCredential: M.D.
Location Address2900 WEST OKLAHOMA AVE, 2ND FLOOR GALLERIAMilwaukee, WI 53215
Mailing Address2900 West Oklahoma Ave, 2nd Floor GalleriaMilwaukee, WI 53215 · (414) 649-6572 · Fax (414) 649-5815
Phone(414) 649-6572
Fax(414) 649-5815
Sole ProprietorYes
Medical School CMSLoyola University Of Chicago, Stritch School Of MedicineGraduated 2005
Enumeration DateDecember 14, 2006
Last NPPES UpdateDecember 1, 20213 updates tracked since enumeration
NPPES CertifiedDecember 1, 2021
✔ NPI 1437211539 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RC0200X
License✔ Licensed in WI · 49725-020
Definition
An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Also ListedInternal MedicineTaxonomy 207R00000X · License 49725-020 (WI)
Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License 49725-020 (WI)
2900 WEST OKLAHOMA AVE, Milwaukee, WI 53215
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Secondary Practice Location 1

Location 1945 N 12th StMilwaukee, WI 53233-1305 · Phone (414) 219-2000 · Fax (414) 219-4941

Other Identifiers 1

Medicaid1437211539WI

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. James Daniel Prahl 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 ID8426213331
PECOS Enrollment IDI20141008002300
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 Reassignments

3

Medicare enrollment records show James Prahl reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Aurora Medical Group, Inc.
0.4 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
Lakeshore Medical Clinic, LLC
4.0 mi
Family Medicine
2000 E LAYTON AVE STE 100
Saint Francis, WI 53235
  • Reassigned Medicare billing, Wisconsin enrollment
  • 960 clinicians in this Medicare group
NPI 1003861188 (414) 744-6589
Ascension Medical Group-Southeast Wisconsin Inc
6.1 mi
Anesthesiology
2301 N LAKE DR
Milwaukee, WI 53211
  • Reassigned Medicare billing, Wisconsin enrollment
  • 1,343 clinicians in this Medicare group
NPI 1194473066 (414) 585-1000

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

Areas of Expertise CMS Part B claims 3

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.

Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
164 services71 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
57 services46 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
15 services14 patients

Hospital Affiliations CMS Care Compare 2

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

Aurora St Lukes Medical Center

Acute Care Hospitals · Milwaukee, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520138
Location2900 W Oklahoma AveMilwaukee, WI 53215 · Milwaukee County
Emergency services Birthing friendly

Aurora Medical Center Kenosha

Acute Care Hospitals · Kenosha, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520189
Location10400 75th StKenosha, WI 53142 · Kenosha County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53215 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
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 18

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
4 suppliers24 claims24 services$36.04 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
3 suppliers12 claims12 services$76.38 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
3 suppliers11 claims25 services$29.46 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
4 suppliers20 claims82 services$13.98 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
4 suppliers23 claims23 services$45.99 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
6 suppliers26 claims26 services$15.83 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 James Prahl's NPI number?

The NPI number for James Prahl is 1437211539. It was assigned to this individual provider in the NPPES registry on December 14, 2006.

Where is James Prahl located?

James Prahl practices at 2900 West Oklahoma Ave 2nd Floor Galleria, Milwaukee, WI 53215. The listed phone number is (414) 649-6572.

What is James Prahl's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Is James Prahl enrolled in Medicare?

Yes. James Prahl 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.

Which organizations bill Medicare for James Prahl's services?

According to the CMS Revalidation Reassignment List (October 2026 release), James Prahl reassigns Medicare benefits to 3 organizations: Aurora Medical Group, Inc. (Milwaukee, WI), Lakeshore Medical Clinic, LLC (Saint Francis, WI) and Ascension Medical Group-Southeast Wisconsin Inc (Milwaukee, WI). Each 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 James Prahl's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does James Prahl accept?

Health plans from Aspirus Health Plan and CareSource (Common Ground Healthcare) list James Prahl 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 James Prahl affiliated with any hospitals?

According to CMS data, James Prahl is affiliated with Aurora St Lukes Medical Center and Aurora Medical Center Kenosha.

When was this NPI record last updated?

The NPPES record for James Prahl was last updated on December 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.