Individual provider Active NPI

Ishu Kumar

  • Certified Registered Nurse Anesthetist
  • Staten Island, NY
National Provider Identifier
1043631013
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
599018 Issued in NY
Practice address
411 Holdridge Ave
Staten Island, NY 10312-2174
Phone
(646) 358-2549
NPI assigned
Dec 18, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 599018 NY Primary

Addresses

Primary practice location

411 Holdridge Ave
Staten Island, NY 10312-2174

Mailing address

411 Holdridge Ave
Staten Island, NY 10312-6029
Phone (646) 358-2549

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140224000168 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608006424 Reassigns benefits to 6 organizations
I20240313000232 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608006424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Rutgers New Jersey Medical School, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore - Lij Anesthesiology, PCGroup PAC ID 1153602453, 990 clinicians
PRS Endoscopy Associates LLCGroup PAC ID 7810172343, 2 clinicians

Practice addresses (Care Compare)

2 Centerock Rd
West Nyack, NY 10994-2215
Phone (914) 666-8866

305 Seguine Ave
Staten Island, NY 10309-3709
Phone (718) 605-5000

4277 Richmond Ave
Suite 1
Staten Island, NY 10312-6241
Phone (718) 227-1282

Hospital & facility affiliations

  • Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
94.87
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
599018NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians of University Hospital, PC CurrentSince Nov 1, 2016 Accepting new patients
Physicians of University Hospital, PC CurrentSince Nov 1, 2016 Accepting new patients
Digestive Diseases Diagnostic & Treatment Center LLC CurrentSince May 1, 2017 Accepting new patients
North Shore - Lij Anesthesiology, PC CurrentSince Jul 1, 2019 Accepting new patients
PRS Endoscopy Associates LLC CurrentSince Jan 1, 2024 Accepting new patients
Rwjbh Observation Associates LLC CurrentSince Jan 30, 2024 Accepting new patients
New Day Medical PC CurrentSince Sep 18, 2025 Accepting new patients
Tristar Endoscopy LLC CurrentSince Jan 1, 2024 Accepting new patients
Anu Sampat M.D. P.C. Past Accepting new patients

Locations

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

99 State Route 37 W
Toms River, NJ 08755
Phone (732) 240-8000

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

195 E Main St
Huntington, NY 11743
Phone (631) 385-8677

40 E 10th St
Ste 1W
New York, NY 10003
Phone (212) 344-9524

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458

401 Seaview Ave
Lowr
Staten Island, NY 10305
Phone (718) 226-6186

1 Edgewater St
Fl 6
Staten Island, NY 10305
Phone (718) 226-1047

2 Centerock Rd
West Nyack, NY 10994
Phone (844) 592-7009

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Organizations & group practices 9

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 1

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": "1387324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1043631013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 HOLDRIDGE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103126029",
            "telephone_number": "646-358-2549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 HOLDRIDGE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103122174",
            "telephone_number": "646-358-2549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "ISHU",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-18",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "599018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.