Individual provider Active NPI

Preethi Kumar, D.O.

  • Family Medicine Physician
  • Cedar Knolls, NJ
National Provider Identifier
1205222437
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB10170400 Issued in NJ
Practice address
11 Saddle Rd
Cedar Knolls, NJ 07927-1901
Phone
(973) 267-2122
NPI assigned
Apr 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB10170400 NJ Primary

Addresses

Primary practice location

11 Saddle Rd
Cedar Knolls, NJ 07927-1901

Mailing address

PO Box 416457
Boston, MA 02241-6457

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220901001441 NY Practitioner - Osteopathic Manipulative Medicine 7517226566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meeting House Lane Medical Practice PCGroup PAC ID 6800972589, 125 clinicians

Practice addresses (Care Compare)

147 Beach Rd
Suite a
Westhampton Beach, NY 11978-1733
Phone (631) 288-7746

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB10170400NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meeting House Lane Medical Practice PC CurrentSince Aug 16, 2022 Accepting new patients

Locations

325 Meeting House Ln
Ste 403
Southampton, NY 11968
Phone (631) 283-2100

147 Beach Rd
Ste A
Westhampton Beach, NY 11978
Phone (631) 288-7746

Networks

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

Interoperability endpoints

  • Direct secure messaging: preethi.kumar.p3@direct.shproviders.nextgenshare.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 6

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": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512691200000",
    "number": "1205222437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 SADDLE RD",
            "city": "CEDAR KNOLLS",
            "state": "NJ",
            "postal_code": "079271901",
            "telephone_number": "973-267-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "PREETHI",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-14",
        "last_updated": "2017-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB10170400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Knolls, NJ

Sources for this page

Verify at the official NPI Registry.