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DR. PRADEEP S KULKARNI M.D.
NPI 1609828292
Internal Medicine - Pulmonary Disease in Springfield, IL

Active since May 16, 2006PECOS Enrolled
543 W MILLER ST, SPRINGFIELD, IL 62702(217) 522-5596(217) 522-5599 Get Directions Write a Review

NPPES record last updated: July 17, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Pradeep S Kulkarni M.d. NPPES

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

DR. PRADEEP S KULKARNI M.D. (NPI 1609828292) is an individual pulmonary disease provider in Springfield, Illinois, licensed in Illinois (036057354) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1609828292
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameDR. PRADEEP S KULKARNICredential: M.D.
Location Address543 W MILLER STSpringfield, IL 62702-4978
Mailing Address543 W Miller StSpringfield, IL 62702-4978 · (217) 522-5596 · Fax (217) 522-5599
Phone(217) 522-5596
Fax(217) 522-5599
Sole ProprietorNo
Enumeration DateMay 16, 2006
Last NPPES UpdateJuly 17, 2017
✔ NPI 1609828292 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License✔ Licensed in IL · 036057354
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 036057354 (IL)
543 W MILLER ST, Springfield, IL 62702
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Other Identifiers 3

Medicaid0360573541IL
Medicare UPINC43723IL
Medicare ID-Type Unspecified608640IL

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Pradeep S Kulkarni M.d. 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62702 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
$127.46 typical visit price
range $54.80 – $168.44
Typical copayment $31.86 (range $13.70 – $42.11)
Most-billed visit code 99204
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation
Percentage of patients aged 18 years and older with a diagnosis of COPD who had spirometry results documented
100%481 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
97%386 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
10%167 patients1/55-star benchmark: 99%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
100%568 patients5/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
34%618 patients2/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
81%167 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
1%167 patients1/55-star benchmark: 59%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 13

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

Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
8 suppliers34 claims34 services$102.21 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
8 suppliers27 claims73 services$36.25 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
5 suppliers15 claims82 services$19.16 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 suppliers15 claims15 services$53.76 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
7 suppliers33 claims33 services$19.68 avg. paid by Medicare
Tubing used with positive airway pressure device A7037
DME-Other DME · category DE001N
7 suppliers33 claims33 services$15.38 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

DR. DONALD G GUMPRECHT M.D.
Internal Medicine (Critical Care Medicine)
543 W MILLER ST
SPRINGFIELD, IL 62702
Sangamon County (217) 522-5596
CENTRAL ILLINOIS ALLERGY AND RESPIRATORY
Internal Medicine (Allergy & Immunology)
543 W MILLER ST
SPRINGFIELD, IL 62702
Sangamon County (217) 522-5596

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 Kulkarni's NPI number?

The NPI number for Pradeep Kulkarni is 1609828292. It was assigned to this individual provider in the NPPES registry on May 16, 2006.

Where is Pradeep Kulkarni located?

Pradeep Kulkarni practices at 543 W Miller St, Springfield, IL 62702. The listed phone number is (217) 522-5596.

What is Pradeep Kulkarni's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Pradeep Kulkarni enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Pradeep Kulkarni was last updated on July 17, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.