BIRENDRA S KUMAR MD
NPI 1063491066
Internal Medicine - Hematology & Oncology in Mankato, MN

Active since January 10, 2006PECOS EnrolledAccepts Medicare Assignment
81.72/100
CMS Quality Rating
1230 E MAIN ST, MANKATO CLINIC AT MAIN STREET, MANKATO, MN 56001(507) 625-1811 Get Directions Write a Review

NPPES record last updated: September 9, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Birendra S Kumar Md NPPES

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

BIRENDRA S KUMAR MD (NPI 1063491066) is an individual hematology & oncology provider in Mankato, Minnesota, licensed in Minnesota (39113) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with M Health Fairview Southdale Hospital, and is a graduate of Other (1991).

NPPES Registry Identity

NPI1063491066
Entity TypeIndividualMale
Primary Taxonomy207RH0003X
Provider Legal NameBIRENDRA S KUMARCredential: MD
Location Address1230 E MAIN ST, MANKATO CLINIC AT MAIN STREETMankato, MN 56001-5066
Mailing Address110105 Pioneer W Trl 302Chaska, MN 55318-2680 · (952) 361-5800 · Fax (952) 361-5858
Sole ProprietorNo
Medical School CMSOtherGraduated 1991
Enumeration DateJanuary 10, 2006
Last NPPES UpdateSeptember 9, 2016
NPI 1063491066 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0003X
License Licensed in MN · 39113
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Also ListedInternal MedicineTaxonomy 207R00000X · License 39113 (MN)
1230 E MAIN ST, Mankato, MN 56001

Other Identifiers 12

Other41084933956001C219Champus
Other773738MN · Americas Ppo
Other335L2KUMN · Bcbs
Other3600541MN · Medica
Medicaid0593046IA
OtherNA2951011969MN · Preferred One
OtherHP21623MN · Health Partners
Medicare ID-Type Unspecified830000408MN
Medicaid256514500MN
Medicare UPING35497
Other115710MN · Ucare
OtherP00211303Rr Medicare

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

Birendra S Kumar Md 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 ID3375516123
PECOS Enrollment IDI20040819001432
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 12

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.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
276 services118 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.
255 services147 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
49 services43 patients
Telephone medical discussion with physician, 11-20 minutes 99442
This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.
32 services22 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
30 services25 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
29 services29 patients

Hospital Affiliations CMS Care Compare 4

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

M Health Fairview Southdale Hospital

Acute Care Hospitals · Edina, MN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240078
Location6401 France Avenue SouthEdina, MN 55435 · Hennepin County
Emergency services Birthing friendly

M Health Fairview University Of Mn

Acute Care Hospitals · Minneapolis, MN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240080
Location2450 Riverside AvenueMinneapolis, MN 55454 · Hennepin County
Emergency services Birthing friendly

M Health Fairview Ridges Hospital

Acute Care Hospitals · Burnsville, MN
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number240207
Location201 East Nicollet BoulevardBurnsville, MN 55337 · Dakota County
Emergency services Birthing friendly

M Health Fairview St John's Hospital

Acute Care Hospitals · Maplewood, MN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240210
Location1575 Beam AvenueMaplewood, MN 55109 · Ramsey County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 56001 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
$168.28 typical visit price
range $56.00 – $168.28
Typical copayment $42.07 (range $14.00 – $42.07)
Most-billed visit code 99205
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.72/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality69.86
Promoting Interoperability100
Improvement Activities40
Cost59.73

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.

Surgery
1230 E MAIN ST
MANKATO, MN 56001
Internal Medicine (Hematology & Oncology)
1230 E MAIN ST
MANKATO, MN 56001
Nurse Practitioner (Family)
1230 E MAIN ST
MANKATO, MN 56001
Nurse Practitioner (Family)
1230 E MAIN ST
MANKATO, MN 56001
Nurse Practitioner (Family)
1230 E MAIN ST
MANKATO, MN 56001
Physical Therapist
1230 E MAIN ST
MANKATO, MN 56001
Physician Assistant
1230 E MAIN ST
MANKATO, MN 56001
Physician Assistant (Medical)
1230 E MAIN ST
MANKATO, MN 56001

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 Birendra Kumar's NPI number?

The NPI number for Birendra Kumar is 1063491066. It was assigned to this individual provider in the NPPES registry on January 10, 2006.

Where is Birendra Kumar located?

Birendra Kumar practices at 1230 E Main St Mankato Clinic At Main Street, Mankato, MN 56001. The listed phone number is (507) 625-1811.

What is Birendra Kumar's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Is Birendra Kumar enrolled in Medicare?

Yes. Birendra Kumar 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 Birendra Kumar accept?

Health plans from Medica and Sanford Health Plan list Birendra Kumar 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 Birendra Kumar affiliated with any hospitals?

According to CMS data, Birendra Kumar is affiliated with M Health Fairview Southdale Hospital, M Health Fairview University Of Mn, M Health Fairview Ridges Hospital and M Health Fairview St John's Hospital.

When was this NPI record last updated?

The NPPES record for Birendra Kumar was last updated on September 9, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.