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DR. ANIL KUMAR M.D.
NPI 1093778359
Internal Medicine in Allentown, PA

Active since April 08, 2006PECOS EnrolledAccepts Medicare Assignment
4332 CREEK RD, ALLENTOWN, PA 18104(484) 619-3160 Get Directions Write a Review

NPPES record last updated: January 12, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Anil Kumar M.d. NPPES

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

DR. ANIL KUMAR M.D. (NPI 1093778359) is an individual internal medicine provider in Allentown, Pennsylvania, licensed in Pennsylvania (MD429319) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Schuylkill Medical Center - South Jackson Street, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1093778359
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. ANIL KUMARCredential: M.D.
Location Address4332 CREEK RDAllentown, PA 18104-3397
Mailing Address4332 Creek RdAllentown, PA 18104-3397 · (484) 619-3160
Phone(484) 619-3160
Sole ProprietorYes
Medical School CMSOtherGraduated 1998
Enumeration DateApril 8, 2006
Last NPPES UpdateJanuary 12, 2017
✔ NPI 1093778359 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in PA · MD429319✔ Licensed in IL · 036113231
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
4332 CREEK RD, Allentown, PA 18104
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Other Identifiers 3

Medicare PINK21451IL
Medicare UPINI42880
Medicaid036113231IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.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. Anil Kumar 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 ID648295121
PECOS Enrollment IDI20061013000014
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 5

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
72 services44 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.
43 services26 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.
37 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.
24 services24 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
18 services12 patients

Hospital Affiliations CMS Care Compare

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

Schuylkill Medical Center - South Jackson Street

Acute Care Hospitals · Pottsville, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390030
Location420 South Jackson StreetPottsville, PA 17901 · Schuylkill County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18104 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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 2

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers16 claims16 services$19.91 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers16 claims16 services$111.62 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Anil Kumar's NPI number?

The NPI number for Anil Kumar is 1093778359. It was assigned to this individual provider in the NPPES registry on April 8, 2006.

Where is Anil Kumar located?

Anil Kumar practices at 4332 Creek Rd, Allentown, PA 18104. The listed phone number is (484) 619-3160.

What is Anil Kumar's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Anil Kumar enrolled in Medicare?

Yes. Anil 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 Anil Kumar accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Anil 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 Anil Kumar affiliated with any hospitals?

According to CMS data, Anil Kumar is affiliated with Schuylkill Medical Center - South Jackson Street.

When was this NPI record last updated?

The NPPES record for Anil Kumar was last updated on January 12, 2017. 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.