Individual provider Active NPI

Nishita Samanth Kumar, M.D.

  • Surgery Physician
  • Santa Monica, CA
National Provider Identifier
1366020596
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A206583 Issued in CA
Practice address
2121 Santa Monica Blvd
Santa Monica, CA 90404-2303
Phone
(310) 315-6125
NPI assigned
Mar 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PENDING MO
Surgery Physician 208600000X A206583 CA Primary

Addresses

Primary practice location

2121 Santa Monica Blvd
Santa Monica, CA 90404-2303

Mailing address

2121 Santa Monica Blvd
Santa Monica, CA 90404-2303

Other practice location 1

1402 S Grand Blvd
Saint Louis, MO 63104-1004
Phone (314) 977-4708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20210701003670 MO Order and Referring Only - General SurgeryPractitioner - General Surgery 6608277215

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Saint Louis University School of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1402 S Grand Blvd
RM M260
Saint Louis, MO 63104-1004

2020 Santa Monica Blvd
FL 3
Santa Monica, CA 90404-1878

21311 Madrona Ave
Suite 101
Torrance, CA 90503-5970

PO
Suite 3029
Los Angeles, CA 91110

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1366020596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 SANTA MONICA BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 SANTA MONICA BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042303",
            "telephone_number": "310-315-6125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1402 S Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041004",
            "country_code": "US",
            "telephone_number": "314-977-4708",
            "fax_number": "314-977-1642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "NISHITA",
        "middle_name": "SAMANTH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-30",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A206583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.