Individual provider Active NPI

Malini Kumar, D.O.

  • Pediatrics Physician
  • Downers Grove, IL
National Provider Identifier
1578859476
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036134625 Issued in IL
Practice address
5207 Main St
Downers Grove, IL 60515-4652
Phone
(630) 964-6049
NPI assigned
Jun 20, 2011
Last updated
Aug 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 281123 NY
Pediatrics Physician 208000000X 036134625 IL Primary

Addresses

Primary practice location

5207 Main St
Downers Grove, IL 60515-4652

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other identifiers 2

IdentifierTypeStateIssuer
00695941MedicaidNY
036134625MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mkumar184982@direct.edward.org
Direct Messaging Address mkumar184982@dulyhealthandcare.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, NY2 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
I20141016001096 IL Practitioner - Pediatric Medicine 9436370467 Reassigns benefits to 1 organization
I20170109002726 NY Practitioner - Pediatric Medicine 9436370467 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036134625ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell Pediatrics Current Accepting new patients
Weill Medical College of Cornell CurrentSince Dec 1, 2016 Accepting new patients
Weill Medical College of Cornell CurrentSince Dec 1, 2016 Accepting new patients
Dupage Medical Group LTD CurrentSince Nov 5, 2018 Accepting new patients
Dupage Medical Group LTD CurrentSince Nov 5, 2018 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

3743 Highland Ave
Ste 1003
Downers Grove, IL 60515
Phone (630) 964-6049

5207 Main St
Downers Grove, IL 60515
Phone (630) 435-9888

3611 21st St
Long Island City, NY 11106
Phone (718) 482-7488

1305 York Ave
Fl 8
New York, NY 10021
Phone (646) 962-3176

170 William St
New York, NY 10038
Phone (212) 238-0100

2315 Broadway
New York, NY 10024
Phone (212) 746-3278

525 E 68th St
#585
New York, NY 10065
Phone (212) 746-2059

525 E 68th St
#M6
New York, NY 10065
Phone (212) 746-3558

Interoperability endpoints

  • Direct secure messaging: malini.kumar@chn.eclinicaldirectplus.com
  • Direct secure messaging: mkumar184982@dulyhealthandcare.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1578859476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5207 MAIN ST",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605154652",
            "telephone_number": "630-964-6049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "MALINI",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-20",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "281123",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036134625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00695941",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036134625",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkumar184982@direct.edward.org",
            "affiliation": "N",
            "address_1": "5207 Main St",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605154652",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkumar184982@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "5207 Main St",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605154652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.