Individual provider Active NPI

Kelash Kumar, MD

  • Internal Medicine Physician
  • Glen Cove, NY
National Provider Identifier
1366964249
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
305728 Issued in NY
Practice address
101 Saint Andrews LN
Glen Cove, NY 11542-2254
Phone
(516) 674-7300
NPI assigned
Jul 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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
Internal Medicine Physician 207R00000X 305728 NY Primary

Addresses

Primary practice location

101 Saint Andrews LN
Glen Cove, NY 11542-2254

Mailing address

1100 Avalon SQ # 1305
Glen Cove, NY 11542-2877
Phone (347) 915-8761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201026001034 NY Practitioner - Internal MedicinePractitioner - Hospitalist 0648690966 Reassigns benefits to 3 organizations
I20260622000235 CA Practitioner - Internal Medicine 0648690966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

1721 W Yosemite Ave
Manteca, CA 95337-5130
Phone (209) 825-3700

1777 W Yosemite Ave
Manteca, CA 95337-5130
Phone (209) 825-3700

1779 W Yosemite Ave
Manteca, CA 95337-5130
Phone (209) 825-3700

1789 W Yosemite Ave
Manteca, CA 95337-5130
Phone (209) 825-3700

7373 W Lane
Stockton, CA 95210-3377
Phone (209) 476-2000

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Maimonides Primary Care FPP Internal Medicine CurrentSince Aug 17, 2020 Accepting new patients
Maimonides Medical Center Current Accepting new patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Sep 12, 2024 Accepting new patients
Maimonides Faculty Practice Plan Internal Medicine CurrentSince Aug 17, 2020 Accepting new patients

Locations

4508 16th Ave
Brooklyn, NY 11204
Phone (718) 972-8018

1250 57th St
Brooklyn, NY 11219
Phone (718) 283-5700

4802 10th Ave
Brooklyn, NY 11219
Phone (718) 283-8724

101 Saint Andrews Ln
Glen Cove, NY 11542
Phone (516) 674-7300

300 Community Dr
Plandome, NY 11030

Interoperability endpoints

  • Direct secure messaging: kelashkumar@mai.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1366964249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 AVALON SQ # 1305",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422877",
            "telephone_number": "347-915-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SAINT ANDREWS LN",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422254",
            "telephone_number": "516-674-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "KELASH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-12",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "305728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

Verify at the official NPI Registry.