Individual provider Active NPI

Nidhi Kumar, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Fond Du Lac, WI
National Provider Identifier
1154494409
Registry record updated Jan 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
47027 Issued in WI
Practice address
430 E Division St
Fond Du Lac, WI 54935-4560
Phone
(920) 926-5886
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 47027 WI Primary

Addresses

Primary practice location

430 E Division St
Fond Du Lac, WI 54935-4560

Mailing address

430 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 926-5886

Other identifiers 1

IdentifierTypeStateIssuer
34787200MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20070728000224 WI Practitioner - Pathology 0345341772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Pathologists, SCGroup PAC ID 9739285479, 19 clinicians

Practice addresses (Care Compare)

700 S Park St
Madison, WI 53715-1830
Phone (608) 251-6100

Hospital & facility affiliations

  • SSM Health St Agnes Hospital-Fond Du Lac Hospital, Fond Du Lac, WI, CCN 520088
  • Waupun Memorial Hospital Hospital, Waupun, WI, CCN 521327
  • Ripon Medical Center Hospital, Ripon, WI, CCN 521321

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47027WIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Pathologists, SC CurrentSince Mar 23, 2020 Accepting new patients

Locations

430 E Division St
Fond du Lac, WI 54935
Phone (920) 926-4200

700 S Park St
Madison, WI 53715
Phone (608) 260-2900

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389312000000",
    "number": "1154494409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354560",
            "telephone_number": "920-926-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354560",
            "telephone_number": "920-926-5886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "NIDHI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2014-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WI",
            "license": "47027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34787200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

Verify at the official NPI Registry.