Individual provider Active NPI

Mukesh Kumar, MD

  • Internal Medicine Physician
  • Derby, CT
National Provider Identifier
1104347665
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
65432 Issued in CT
Practice address
130 Division St
Derby, CT 06418-1326
Phone
(203) 732-1330
Fax
(203) 732-1332
NPI assigned
Jul 5, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 65432 CT Primary

Addresses

Primary practice location

130 Division St
Derby, CT 06418-1326

Mailing address

67 Maple Ave
Derby, CT 06418-1328
Phone (203) 732-1256

Other practice location 1

111 Wakelee Ave
Ansonia, CT 06401-1151
Phone (203) 308-2781

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20200723000304 CT Practitioner - Internal Medicine 5799022596 Reassigns benefits to 4 organizations
I20231216000080 NY Practitioner - Internal Medicine 5799022596 Reassigns benefits to 2 organizations
I20240229002710 CT Practitioner - HospitalistPractitioner - Internal Medicine 5799022596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Griffin Faculty Physicians IncGroup PAC ID 7618871997, 125 clinicians
Hospital for Special CareGroup PAC ID 7810985637, 51 clinicians
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

130 Division St
Derby, CT 06418-1326
Phone (203) 732-1330

2150 Corbin Ave
New Britain, CT 06053-2266
Phone (860) 827-4994

400 E Main St
Mount Kisco, NY 10549-3417
Phone (914) 666-1371

50 Gaylord Farm Rd
Wallingford, CT 06492-2828
Phone (203) 679-3553

56 Franklin St
Waterbury, CT 06706-1253
Phone (203) 709-6000

Hospital & facility affiliations

  • Trinity Health of New England at Home Home health agency, Hartford, CT, CCN 077005
  • Saint Mary'S Hospital Hospital, Waterbury, CT, CCN 070016
  • Griffin Hospital Hospital, Derby, CT, CCN 070031
  • Phelps Hospital Hospital, Sleepy Hollow, NY, CCN 330261
  • The Hospital of Central Connecticut Hospital, New Britain, CT, CCN 070035
  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65432CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC Internal Medicine CurrentSince Nov 1, 2023 Accepting new patients
Griffin Faculty Physicians, Inc. Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
Mill Hill Medical Consultants Inc CurrentSince Mar 25, 2024 Accepting new patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Mar 25, 2024 Accepting new patients
Hospital for Special Care CurrentSince Nov 21, 2022 Accepting new patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Nov 1, 2023 Accepting new patients
Gaylord Hospital, Inc. CurrentSince Apr 3, 2023 Accepting new patients
Trinity Health of New England Provider Network Organization Inc Internal Medicine CurrentSince Dec 19, 2021 Accepting new patients
Montefiore New Rochelle Hospital CurrentSince Dec 29, 2024 Accepting new patients
Trinity Health of New England Provider Network Organization Inc Internal Medicine CurrentSince Dec 19, 2021 Accepting new patients
Phelps Memorial Hospital Association Past Accepting new patients
Northern Westchester Hospital Association Past Accepting new patients

Locations

111 Wakelee Ave
Ansonia, CT 06401
Phone (203) 308-2781

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

130 Division St
Derby, CT 06418
Phone (203) 732-1330

67 Maple Ave
Derby, CT 06418
Phone (203) 732-0699

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

2150 Corbin Ave
New Britain, CT 06053
Phone (860) 223-2761

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

50 Gaylord Farm Rd
Wallingford, CT 06492
Phone (203) 679-3553

133 Scovill St
Ste 102
Waterbury, CT 06706
Phone (203) 270-5575

133 Scovill St
Ste 306
Waterbury, CT 06706
Phone (203) 709-3667

133 Scovill St
Ste 209
Waterbury, CT 06706
Phone (203) 709-3800

111 E 210th St
Bronx, NY 10467

400 E Main St
Mount Kisco, NY 10549
Phone (914) 666-1200

16 Guion Pl
New Rochelle, NY 10801
Phone (914) 365-3680

300 Community Dr
Plandome, NY 11030

701 N Broadway
Sleepy Hollow, NY 10591
Phone (914) 366-3140

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir.hfsc.org/R4/open-Prod
  • Direct secure messaging: mkumar2388661@direct.trinity-health.org
  • Direct secure messaging: mkumar66255@northwell.direct-ci.com

Organizations & group practices 12

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 8

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": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1104347665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 MAPLE AVE",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181328",
            "telephone_number": "203-732-1256",
            "fax_number": "203-732-1539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 DIVISION ST",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181326",
            "telephone_number": "203-732-1330",
            "fax_number": "203-732-1332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Wakelee Ave",
            "address_purpose": "LOCATION",
            "city": "Ansonia",
            "state": "CT",
            "postal_code": "064011151",
            "country_code": "US",
            "telephone_number": "203-308-2781",
            "fax_number": "203-308-2726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "MUKESH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-05",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "65432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, CT

Sources for this page

Verify at the official NPI Registry.