Individual provider Active NPI

Anisha R Kumar

  • Otolaryngology/Facial Plastic Surgery Physician
  • Stony Brook, NY
National Provider Identifier
1306208673
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
308442 Issued in NY
Practice address
101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone
(631) 444-0580
NPI assigned
Mar 24, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 308442 NY Primary
Otolaryngology Physician 207Y00000X 308442 NY
Otolaryngology Physician 207Y00000X 5969 MD

Addresses

Primary practice location

101 Nicolls Rd
Stony Brook, NY 11794-0001

Mailing address

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-0580

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
I20210428001872 NY Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 7113212614 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
Stanford University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

255 W Montauk Hwy
Life Care Ctr
Hampton Bays, NY 11946
Phone (631) 723-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5969MDMDOtolaryngology Physician
308442NYMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
White Plains Physician Services PC CurrentSince Oct 17, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Otolaryngology CurrentSince Jan 19, 2021 Accepting new patients
Stony Brook Surgical Associates, University Faculty Practice Corporati CurrentSince Feb 2, 2026 Accepting new patients
Icahn School of Medicine at Mount Sinai Otolaryngology CurrentSince Jul 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jan 19, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Stony Brook Anaesthesiology, University Faculty Practice Corporation Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Stony Brook Children'S Service, University Faculty Practice Corporatio Past Accepting new patients

Locations

23 S Howell Ave
Ste F
Centereach, NY 11720

500 Commack Rd
Ste 102A
Commack, NY 11725
Phone (631) 638-0130

7901 Broadway
Rm A119
Elmhurst, NY 11373
Phone (718) 334-3915

4 Smith Haven Mall
Ste 101
Lake Grove, NY 11755
Phone (631) 444-7337

185 Kisco Ave
Ste 300
Mount Kisco, NY 10549
Phone (914) 242-2020

37 Research Way
Setauket, NY 11733
Phone (631) 444-4121

O Level 2
Rm 664
Stony Brook, NY 11794

101 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-2065

122 Maple Ave
White Plains, NY 10601
Phone (914) 285-9490

122 Maple Ave
Fl 9
White Plains, NY 10601
Phone (914) 849-3755

Networks

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

Interoperability endpoints

  • Direct secure messaging: akumar1694675@nychhc.direct-ci.com

Organizations & group practices 11

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": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1306208673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "ANISHA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-24",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "NY",
            "license": "308442",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NY",
            "license": "308442",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MD",
            "license": "5969",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.