Individual provider Active NPI

Prashant Kumar, MD

  • Pain Medicine (Anesthesiology) Physician
  • Worcester, MA
National Provider Identifier
1073756441
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
258822 Issued in MA
Practice address
102 Shore Drive
Ste 502
Worcester, MA 01605-3154
Phone
(508) 425-7670
Fax
(508) 425-7671
NPI assigned
Apr 14, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 036.132266 IL
Pain Medicine (Anesthesiology) Physician 207LP2900X 258822 MA Primary

Addresses

Primary practice location

102 Shore Drive
Ste 502
Worcester, MA 01605-3154

Mailing address

102 Shore Drive
Ste 502
Worcester, MA 01605-3154
Phone (508) 425-7670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141001000961 MA Practitioner - Anesthesiology 3779703491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Vincent Physician Services IncGroup PAC ID 8921056276, 71 clinicians

Practice addresses (Care Compare)

1 Eaton PL
Worcester, MA 01608-1232

123 Summer St
Worcester, MA 01608-1216

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.132266ILMDPain Medicine (Anesthesiology) Physician
258822MAMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Vincent Physician Services, Inc. CurrentSince Sep 1, 2014 Accepting new patients

Locations

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

102 Shore Dr
Ste 502
Worcester, MA 01605
Phone (508) 425-7670

123 Summer St
#273
Worcester, MA 01608
Phone (508) 363-6327

Interoperability endpoints

  • Direct secure messaging: prashant.kumar.1@626.direct.athenahealth.com

Organizations & group practices 1

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 4

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": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405555200000",
    "number": "1073756441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 SHORE DRIVE",
            "address_2": "STE 502",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053154",
            "telephone_number": "508-425-7670",
            "fax_number": "508-425-7671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 SHORE DRIVE",
            "address_2": "STE 502",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053154",
            "telephone_number": "508-425-7670",
            "fax_number": "508-425-7671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "PRASHANT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-14",
        "last_updated": "2014-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036.132266",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MA",
            "license": "258822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.