DR. SANJAY KUMAR MD
NPI 1063528867
Internal Medicine - Clinical Cardiac Electrophysiology in Weston, WI

Q: What is Sanjay Kumar's NPI number?

The NPI number for Sanjay Kumar is 1063528867. It was assigned to this individual provider in the NPPES registry on August 22, 2006.

Q: What is Sanjay Kumar's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Clinical Cardiac Electrophysiology, with taxonomy code 207RC0001X.

Q: When was this NPI record last updated?

The NPPES record for Sanjay Kumar was last updated on February 16, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 22, 2006PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

3501 CRANBERRY BLVD, WESTON, WI 54476(715) 393-1000 Get Directions Write a Review

NPPES record last updated: February 16, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Sanjay Kumar Md NPPES

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

DR. SANJAY KUMAR MD (NPI 1063528867) is an individual clinical cardiac electrophysiology provider in Weston, Wisconsin, licensed in Wisconsin (62805) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Monmouth Medical Center-southern Campus, and is a graduate of Other (1995).

NPPES Registry Identity

NPI1063528867

Entity TypeIndividualMale

Primary Taxonomy207RC0001X

Provider Legal NameDR. SANJAY KUMARCredential: MD

Location Address3501 CRANBERRY BLVDWeston, WI 54476-5213

Mailing Address1000 N Oak AveMarshfield, WI 54449-5703 · (715) 387-5511

Phone(715) 393-1000

Sole ProprietorNo

Medical School CMSOtherGraduated 1995

Enumeration DateAugust 22, 2006

Last NPPES UpdateFebruary 16, 2024

NPPES CertifiedFebruary 16, 2024

✔ NPI 1063528867 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Clinical Cardiac ElectrophysiologyAllopathic & Osteopathic Physicians

Taxonomy Code207RC0001X

License✔ Licensed in WI · 62805

Definition

A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them.

Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X · License 62805 (WI)

Also ListedHospitalistTaxonomy 208M00000X · License 62805 (WI)

3501 CRANBERRY BLVD, Weston, WI 54476

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, HealthPartners, Medica and more.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

Dr. Sanjay 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 ID1153329255

PECOS Enrollment IDI20141106000212

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 35

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.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

372 services310 patients

Evaluation of implantable heart and blood vessel monitoring system, remote up to 30 days 93297

This service involves remotely monitoring your heart and blood vessel implant system for up to 30 days. Using advanced technology, healthcare professionals can track the device's performance and your health status, ensuring the system is working optimally for your needs.

156 services96 patients

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.

124 services117 patients

Evaluation of cardiac rhythm monitor system, remote up to 30 days 93298

This procedure involves remotely monitoring your heart rhythm for up to 30 days. A small device will record your heart's activity, which can be accessed by your healthcare team. This aids in diagnosing any irregularities or issues with your heart function.

91 services57 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

86 services77 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

84 services83 patients

Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days 93294

This procedure evaluates your pacemaker system remotely for up to 90 days. It checks whether single, dual, multiple lead, or leadless pacemakers are working properly. It's a safe, convenient way to ensure your heart device is functioning optimally.

75 services68 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.

73 services70 patients

Routine electrocardiogram (ecg) using at least 12 leads with tracing 93005

An Electrocardiogram (ECG) is a simple, painless test that records the heart's electrical activity. Using 12 leads attached to your skin, it generates a tracing of your heart rhythm. It helps detect any heart problems by showing the timing and strength of electrical signals passing through each part of your heart.

57 services51 patients

Programming of heart rhythm stimulation after drug infusion 93623

Programming of heart rhythm stimulation after drug infusion is a process to regulate your heartbeat. After a medication is administered into your body, a device is programmed to monitor and correct irregular heart rhythms, ensuring your heart functions optimally.

43 services43 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

39 services35 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

38 services38 patients

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152

This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.

38 services37 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.

36 services35 patients

Evaluation of single, dual, or multiple lead implantable defibrillator system, remote up to 90 days 93295

This procedure involves remotely monitoring your implantable defibrillator system, which can have single, dual, or multiple leads. Over a period of up to 90 days, the system's performance is evaluated to ensure it's working properly and providing the necessary heart rhythm support.

34 services33 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.

31 services20 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

27 services27 patients

Comprehensive electrophysiologic evaluation with catheter destruction of abnormality causing atrial fibrillation (uncoordinated contraction of upper chambers of heart) by pulmonary vein isolation 93656

This is a procedure to treat atrial fibrillation, a condition causing irregular heartbeats. It involves a detailed heart evaluation using electrophysiology. A catheter is then used to destroy the problematic area causing the issue. Specifically, isolation of the pulmonary vein is done to regulate the heartbeat.

24 services24 patients

Insertion of catheters and destruction of tissue to treat abnormal heart rhythm 93655

This procedure involves placing small tubes (catheters) into your heart via a blood vessel. These catheters emit energy that corrects irregular heartbeats by eliminating the problematic heart tissue. It's a common, minimally invasive method to treat abnormal heart rhythms.

21 services21 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

19 services19 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

18 services18 patients

Programming of dual lead pacemaker system 93280

Programming of a dual lead pacemaker system is a procedure to adjust your heart's pacemaker settings. This process involves a small device, called a programmer, that communicates with your pacemaker to ensure it's working optimally for your heart's needs.

17 services16 patients

Ultrasound of heart with color-depicted blood flow, rate and valve function 93325

An ultrasound of the heart, also known as an echocardiogram, uses sound waves to create pictures of your heart. It shows the structure, movement, and blood flow within your heart. This helps assess the heart's health and function, including the valves and rate.

17 services17 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

17 services17 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

17 services17 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

16 services16 patients

Ultrasound of both sides of head and neck blood flow 93880

An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.

16 services16 patients

Insertion of heart rhythm monitor under skin 33285

The insertion of a heart rhythm monitor under the skin is a procedure to track your heart's activity. A small device is placed under your skin, recording your heart's rhythms continuously. This helps identify irregular heartbeats or conditions, aiding in your treatment.

15 services15 patients

External shock to heart to regulate heart beat 92960

This procedure, known as cardioversion, uses an external electrical shock to restore your heart's normal rhythm. It's typically performed when irregular heartbeats, or arrhythmias, are causing severe symptoms and aren't responding to medications.

15 services14 patients

Ultrasound of heart blood flow, valves and chambers, follow-up 93321

This procedure, an echocardiogram, uses sound waves to create images of your heart. It aids in assessing your heart's blood flow, chambers, and valves. It's a follow-up procedure, ensuring that your heart is functioning properly post-treatment.

15 services15 patients

Destruction of tissue of upper heart chamber through tube to treat abnormal heart rhythm 93657

This procedure involves using a tube, or catheter, to access your upper heart chamber. Special tools are then used to destroy a small area of heart tissue causing abnormal rhythm. This helps reset your heart's regular rhythm, improving heart function.

15 services15 patients

Ultrasound evaluation of heart blood vessel with review by radiologist 93662

This is a noninvasive procedure using sound waves to capture images of your heart's blood vessels. A radiologist, an expert in interpreting these images, will review the results to check for any abnormalities. This helps to monitor your heart health.

15 services15 patients

Ultrasound study of one arm or leg veins with compression and maneuvers 93971

This is a non-invasive procedure using sound waves to visualize veins in an arm or leg. It involves applying gentle pressure and performing certain movements. It helps identify any abnormal blood flow or clots, ensuring vascular health.

13 services13 patients

Ultrasound of heart with probe in esophagus, with report 93312

This procedure, called a transesophageal echocardiogram, uses a small probe passed into your esophagus to capture detailed images of your heart. The report provides information about your heart's structure and function.

12 services12 patients

Comprehensive electrophysiologic evaluation with catheter destruction of abnormality of upper chamber of heart causing supraventricular tachycardia (rapid heart rate) 93653

This procedure is a detailed study of your heart's electrical activity. A thin tube (catheter) is inserted into your heart to identify and eliminate the area causing a fast heart rate. This helps restore normal heart rhythm, specifically targeting the upper chamber of the heart.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

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

Monmouth Medical Center-Southern Campus

Acute Care Hospitals · Lakewood, NJ

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310084

Location600 River AveLakewood, NJ 08701 · Ocean County

Emergency services

Marshfield Medical Center

Acute Care Hospitals · Marshfield, WI

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number520037

Location611 St Joseph AveMarshfield, WI 54449 · Wood County

Emergency services Birthing friendly

Marshfield Medical Center - Weston

Acute Care Hospitals · Weston, WI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520202

Location3400 Ministry ParkwayWeston, WI 54476 · Marathon County

Emergency services Birthing friendly

Marshfield Medical Center - Minocqua

Acute Care Hospitals · Minocqua, WI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520212

Location9576 Highway 70Minocqua, WI 54548 · Oneida County

Emergency services Birthing friendly

Flambeau Hospital

Critical Access Hospitals · Park Falls, WI

OwnershipVoluntary non-profit - Private

CMS Certification Number521325

Location98 Sherry AvePark Falls, WI 54552 · Price County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54476 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

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

95.25

Promoting Interoperability

100

Improvement Activities

Leave this field empty

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.

J F HERBERT R MACALALAD MD

Internal Medicine