Individual provider Active NPI

Sanjay Kumar, M.D

  • Vascular Surgery Physician
  • Vineland, NJ
National Provider Identifier
1295938496
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
25MA08084100 Issued in NJ
Practice address
1102 E Chestnut Ave
Vineland, NJ 08360-5002
Phone
(856) 213-6375
Fax
(856) 575-4986
NPI assigned
Jun 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25MA08084100 NJ
Vascular Surgery Physician 2086S0129X 25MA08084100 NJ Primary

Addresses

Primary practice location

1102 E Chestnut Ave
Vineland, NJ 08360-5002

Mailing address

2848 S Delsea Dr
Suite 4B
Vineland, NJ 08360-7042
Phone (856) 205-7070

Other identifiers 1

IdentifierTypeStateIssuer
145246MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20071106000034 NJ Practitioner - Vascular SurgeryPractitioner - General Surgery 6709973902 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kennedy Medical Group Practice, P.C.Group PAC ID 2860616877, 417 clinicians

Practice addresses (Care Compare)

333 Laurel Oak Rd
Voorhees, NJ 08043-4453
Phone (844) 542-2273

Hospital & facility affiliations

  • Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174
  • Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086
  • Cape Regional Medical Center Inc Hospital, Cape May Court House, NJ, CCN 310011

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)48
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Physician Group PA Surgery CurrentSince Jun 5, 2022 Accepting new patients
Kennedy Medical Group Practice P.C. Vascular Surgery CurrentSince May 1, 2023 Accepting new patients
Kennedy Medical Group Practice PC CurrentSince May 1, 2023 Accepting new patients
Kennedy Medical Group Practice, P.C. Vascular Surgery Current Accepting new patients
Atlanticare Physician Group, PA CurrentSince Jun 5, 2022 Accepting new patients

Locations

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

2500 English Creek Ave
Ste 1200
Egg Harbor Twp, NJ 08234
Phone (609) 704-1980

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

333 Laurel Oak Rd
Voorhees, NJ 08043
Phone (856) 344-7360

Organizations & group practices 5

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 3

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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1295938496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2848 S DELSEA DR",
            "address_2": "SUITE 4B",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083607042",
            "telephone_number": "856-205-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 E CHESTNUT AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605002",
            "telephone_number": "856-213-6375",
            "fax_number": "856-575-4986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "SANJAY",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA08084100",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NJ",
            "license": "25MA08084100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145246",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.