NPIMap

Individual provider Active NPI

Ajith J Kumar, MD

  • Nephrology Physician
  • Lewiston, ID
National Provider Identifier
1609952381
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
M000036107 Issued in WA
Practice address
2124 12TH Ave
Lewiston, ID 83501-3502
Phone
(208) 743-9986
Fax
(208) 743-1318
NPI assigned
Oct 27, 2006
Last updated
Mar 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00036107 WA
Nephrology Physician 207RN0300X M-11158 ID
Nephrology Physician 207RN0300X M000036107 WA Primary

Addresses

Primary practice location

2124 12TH Ave
Lewiston, ID 83501-3502

Mailing address

2124 12TH Ave
Lewiston, ID 83501-3502
Phone (208) 743-9986

Other practice location 1

101 W 8th Ave
Spokane, WA 99204-2307
Phone (509) 474-3260

Other identifiers 1

IdentifierTypeStateIssuer
1107572MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080813000494 WA Practitioner - Internal MedicinePractitioner - Nephrology 7719052521 Reassigns benefits to 4 organizations
I20110518000321 ID Practitioner - NephrologyPractitioner - Internal Medicine 7719052521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

101 W 8TH Ave
Spokane, WA 99204-2307
Phone (509) 474-3131

2124 12TH Ave
Lewiston, ID 83501-3502
Phone (208) 743-9986

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-11158IDMDNephrology Physician
M000036107WAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Jul 12, 2023 Accepting new patients
Providence Health & Services Washington Internal Medicine CurrentSince May 5, 2025 Accepting new patients
Multicare Health System CurrentSince Jul 12, 2023 Accepting new patients
Lewis Clark Kidney Center LLC Current Accepting new patients
Multicare Health System Current Accepting new patients
Providence Health & Services Washington CurrentSince May 5, 2025 Accepting new patients
Southeast Iowa Regional Medical Center, Inc. Past Accepting new patients
Donald J. Greggain, M.D. PS Past Accepting new patients
Providence Health & Services - Washington Past Accepting new patients
Northwest Hospital Medicine Physicians LLC Internal Medicine PastSince Jul 10, 2023 Accepting new patients

Locations

222 Southway Ave
Ste A
Lewiston, ID 83501
Phone (208) 743-9986

415 6th St
Lewiston, ID 83501
Phone (208) 750-7445

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

12728 19th Ave SE
Ste 200
Everett, WA 98208
Phone (425) 252-1116

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

101 W 8th Ave
Spokane, WA 99204
Phone (509) 474-3181

5633 N Lidgerwood St
Spokane, WA 99208
Phone (509) 482-0111

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HEICCA/Endpoint/HEICCA

Organizations & group practices 12

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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1609952381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 12TH AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835013502",
            "telephone_number": "208-743-9986",
            "fax_number": "208-743-1318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 12TH AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835013502",
            "telephone_number": "208-743-9986",
            "fax_number": "208-743-1318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 W 8th Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992042307",
            "country_code": "US",
            "telephone_number": "509-474-3260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "AJITH",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00036107",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "ID",
            "license": "M-11158",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "M000036107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1107572",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.