Individual provider Active NPI

Jessica Giduturi Kumar, MD

  • Vascular & Interventional Radiology Physician
  • Miami, FL
National Provider Identifier
1518314772
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
ME155870 Issued in FL
Practice address
1150 NW 14TH St Ste 702
Miami, FL 33136-2118
Phone
(305) 243-2067
NPI assigned
May 18, 2016
Last updated
Dec 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X ME155870 FL Primary

Addresses

Primary practice location

1150 NW 14TH St Ste 702
Miami, FL 33136-2118

Mailing address

1611 NW 12TH Ave
Radiology
Miami, FL 33136-1005
Phone (914) 483-8897

Other practice location 1

1611 NW 12th Ave
Radiology
Miami, FL 33136-1005
Phone (914) 483-8897

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, SC2 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
I20220622001529 FL Practitioner - Diagnostic Radiology 7315326303 Reassigns benefits to 1 organization
I20241024001687 SC Practitioner - Diagnostic Radiology 7315326303 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York Medical College, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pelican II LLCGroup PAC ID 1759484082, 18 clinicians
Charleston Radiologists PAGroup PAC ID 9436054715, 35 clinicians

Practice addresses (Care Compare)

1241 Woodland Ave
Mt Pleasant, SC 29464-3288
Phone (843) 881-4020

2550 Elms Ctr Rd
North Charleston, SC 29406-9844
Phone (866) 717-9687

295 Midland Pkwy
Summerville, SC 29485-8104
Phone (866) 717-9687

501 Robertson Blvd
Walterboro, SC 29488-2787
Phone (866) 717-9687

8330 Medical Plaza Dr
Charleston, SC 29406-9104
Phone (866) 717-9687

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.93 of 100Reported as group
Quality
78.79
Promoting interoperability
100
Improvement activities
40
Cost
71.44

Merit-based Incentive Payment System (MIPS)

Final score
96.22 of 100Reported as group
Quality
95.56
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME155870FLMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Current Accepting new patients
University of Miami CurrentSince Apr 1, 2022 Accepting new patients
University of Miami CurrentSince Apr 1, 2022 Accepting new patients
Charleston Radiologists PA CurrentSince Sep 16, 2024 Accepting new patients
Pelican II, LLC Vascular & Interventional Radiology CurrentSince Sep 16, 2024 Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1150 NW 14th St
Ste 702
Miami, FL 33136
Phone (305) 243-5509

1475 NW 12th Ave
Miami, FL 33136
Phone (305) 243-4200

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1241 Woodland Ave
Mt Pleasant, SC 29464
Phone (843) 881-4020

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1518314772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "RADIOLOGY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "914-483-8897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 NW 14TH ST STE 702",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331362118",
            "telephone_number": "305-243-2067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 NW 12th Ave",
            "address_2": "Radiology",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361005",
            "country_code": "US",
            "telephone_number": "914-483-8897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "JESSICA",
        "middle_name": "GIDUTURI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "FL",
            "license": "ME155870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.