Individual provider Active NPI

Ujjwal Kumar, M.D.

  • Gastroenterology Physician
  • Cedar Rapids, IA
National Provider Identifier
1235570805
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD-45784 Issued in IA
Practice address
Mercy Gastroenterology Clinic
788 8TH Avenue SE
Cedar Rapids, IA 52401
Phone
(319) 369-4542
Fax
(319) 369-4543
NPI assigned
Jul 11, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD-45784 IA Primary

Addresses

Primary practice location

Mercy Gastroenterology Clinic
788 8TH Avenue SE
Cedar Rapids, IA 52401

Mailing address

Mercy Gastroenterology Clinic
788 8TH Avenue SE
Cedar Rapids, IA 52401
Phone (319) 369-4542

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
I20240829000461 NY Practitioner - Gastroenterology 0840582136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

50 Route 25a
Smithtown, NY 11787-1348
Phone (631) 862-3000

Hospital & facility affiliations

  • St Catherine of Siena Hospital Hospital, Smithtown, NY, CCN 330401
  • St Charles Hospital Hospital, Port Jefferson, NY, CCN 330246

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy46
Upper gastrointestinal (GI) endoscopy for acid reflux133

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-45784IAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, PC Current Accepting new patients
CHS Physician Partners, PC CurrentSince Aug 7, 2024 Accepting new patients
CHS Physician Partners, P.C CurrentSince Aug 7, 2024 Accepting new patients

Locations

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225

48 Route 25A
Ste 105
Smithtown, NY 11787
Phone (631) 360-4000

Networks

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

Interoperability endpoints

  • Direct secure messaging: ukumar169479@direct-chsli.net

Organizations & group practices 3

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 2

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": "1373500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1235570805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MERCY GASTROENTEROLOGY CLINIC",
            "address_2": "788 8TH AVENUE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52401",
            "telephone_number": "319-369-4542",
            "fax_number": "319-369-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MERCY GASTROENTEROLOGY CLINIC",
            "address_2": "788 8TH AVENUE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52401",
            "telephone_number": "319-369-4542",
            "fax_number": "319-369-4543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "UJJWAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-11",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IA",
            "license": "MD-45784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.