NPIMap

Individual provider Active NPI

Neeru Kumar, M.D.

  • Nephrology Physician
  • Shirley, NY
National Provider Identifier
1255650685
Registry record updated Apr 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
264917-1 Issued in NY
Practice address
2 Coraci Blvd
Ste 11
Shirley, NY 11967-4833
Phone
(516) 395-9793
NPI assigned
May 25, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 264917-1 NY Primary

Addresses

Primary practice location

2 Coraci Blvd
Ste 11
Shirley, NY 11967-4833

Mailing address

2 Coraci Blvd Ste 11
Shirley, NY 11967-4833
Phone (631) 281-4861

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121113000586 NY Practitioner - NephrologyPractitioner - Internal Medicine 2062663305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NK Medical PCGroup PAC ID 1759505290, 2 clinicians

Practice addresses (Care Compare)

East Patchogue, NY 11772
Phone (516) 395-9793

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
47.19 of 100Reported as individual
Quality
36.67
Improvement activities
0
Cost
75.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
264917-1NYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC PastSince Jun 1, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nkumar504553@nyumc.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Medford Multicare Center for LivingMedford, NY, CCN 335840 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 19, 2023
Dec 19, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555286400000",
    "number": "1255650685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CORACI BLVD STE 11",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119674833",
            "telephone_number": "631-281-4861",
            "fax_number": "631-281-8546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CORACI BLVD",
            "address_2": "STE 11",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119674833",
            "telephone_number": "516-395-9793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "NEERU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-25",
        "last_updated": "2019-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "264917-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shirley, NY

Sources for this page

Verify at the official NPI Registry.