BENJAMIN KUMOR M.D.
NPI 1043445141
Family Medicine - Adult Medicine in Dubuque, IA

Active since May 19, 2009PECOS EnrolledAccepts Medicare Assignment
1515 DELHI ST, SUITE 100, DUBUQUE, IA 52001(563) 557-9111 Get Directions Write a Review

NPPES record last updated: March 23, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 23, 2021, Dec 20, 2016 (2 updates tracked since 2016).

About Benjamin Kumor M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BENJAMIN KUMOR M.D. (NPI 1043445141) is an individual adult medicine provider in Dubuque, Iowa, licensed in Iowa (42572) and active in the NPI registry since May 2009. He is enrolled in Medicare PECOS, is affiliated with Mercyone Dubuque Medical Center, and is a graduate of Ohio State University College Of Medicine (2008).

NPPES Registry Identity

NPI1043445141
Entity TypeIndividualMale
Primary Taxonomy207QA0505X
Provider Legal NameBENJAMIN KUMORCredential: M.D.
Location Address1515 DELHI ST, SUITE 100Dubuque, IA 52001-6389
Mailing Address1515 Delhi St, Suite 100Dubuque, IA 52001-6389 · (563) 557-9111
Sole ProprietorNo
Medical School CMSOhio State University College Of MedicineGraduated 2008
Enumeration DateMay 19, 2009
Last NPPES UpdateMarch 23, 20212 updates tracked since enumeration
NPPES CertifiedMarch 23, 2021
NPI 1043445141 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
License Licensed in IA · 42572
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
1515 DELHI ST, Dubuque, IA 52001

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Benjamin Kumor M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9537388004
PECOS Enrollment IDI20150629000687
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 42

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
554 services317 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
499 services288 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
432 services281 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
299 services209 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
252 services252 patients
Blood test, lipids (cholesterol and triglycerides) 80061
A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
248 services245 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Mercyone Dubuque Medical Center

Acute Care Hospitals · Dubuque, IA
5/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number160069
Location250 Mercy DriveDubuque, IA 52001 · Dubuque County
Emergency services Birthing friendly

Finley Hospital

Acute Care Hospitals · Dubuque, IA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number160117
Location350 North Grandview AvenueDubuque, IA 52001 · Dubuque County
Emergency services Birthing friendly

Guttenberg Municipal Hospital

Critical Access Hospitals · Guttenberg, IA
OwnershipGovernment - Local
CMS Certification Number161312
Location200 Main StreetGuttenberg, IA 52052 · Clayton County
Emergency services

Jackson County Regional Health Center

Critical Access Hospitals · Maquoketa, IA
OwnershipGovernment - Local
CMS Certification Number161329
Location700 W Grove StMaquoketa, IA 52060 · Jackson County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 52001 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.84 typical visit price
range $52.96 – $161.40
Typical copayment $20.46 (range $13.24 – $40.35)
Most-billed visit code 99203
Established Patient
$94.05 typical visit price
range $16.91 – $131.98
Typical copayment $23.51 (range $4.22 – $32.99)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 17

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
12 suppliers58 claims130 services$5.36 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
5 suppliers14 claims14 services$0.97 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
4 suppliers21 claims21 services$37.38 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
5 suppliers25 claims25 services$94.07 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
5 suppliers31 claims44 services$33.25 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
3 suppliers17 claims68 services$21.00 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
1515 DELHI ST, STE 100
DUBUQUE, IA 52001
Hospitalist
1515 DELHI ST, SUITE 100
DUBUQUE, IA 52001
Internal Medicine
1515 DELHI ST, STE 100
DUBUQUE, IA 52001
Internal Medicine
1515 DELHI ST, STE 100
DUBUQUE, IA 52001
Nurse Anesthetist, Certified Registered
1515 DELHI ST, SUITE 300
DUBUQUE, IA 52001
Internal Medicine
1515 DELHI ST, STE 100
DUBUQUE, IA 52001
Internal Medicine
1515 DELHI ST, STE 100
DUBUQUE, IA 52001
Internal Medicine
1515 DELHI ST, STE 100
DUBUQUE, IA 52001

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Benjamin Kumor's NPI number?

The NPI number for Benjamin Kumor is 1043445141. It was assigned to this individual provider in the NPPES registry on May 19, 2009.

Where is Benjamin Kumor located?

Benjamin Kumor practices at 1515 Delhi St Suite 100, Dubuque, IA 52001. The listed phone number is (563) 557-9111.

What is Benjamin Kumor's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

Is Benjamin Kumor enrolled in Medicare?

Yes. Benjamin Kumor is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Benjamin Kumor accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan and 2 other insurers list Benjamin Kumor as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Benjamin Kumor affiliated with any hospitals?

According to CMS data, Benjamin Kumor is affiliated with Mercyone Dubuque Medical Center, Finley Hospital, Guttenberg Municipal Hospital and Jackson County Regional Health Center.

When was this NPI record last updated?

The NPPES record for Benjamin Kumor was last updated on March 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.