DR. KELLY JANE CUMMINGS M.D.
NPI 1104212604
Internal Medicine in New York, NY

Active since April 10, 2015PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
525 EAST 68TH STREET, PAYSON 2, NEW YORK, NY 10065(212) 746-7000 Get Directions Write a Review

NPPES record last updated: October 19, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Kelly Jane Cummings M.d. NPPES

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

DR. KELLY JANE CUMMINGS M.D. (NPI 1104212604) is an individual internal medicine provider in New York, New York, licensed in New York (294062) and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS, is affiliated with New York-presbyterian Hospital, and maintains a secondary practice location in Stony Brook.

NPPES Registry Identity

NPI1104212604
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. KELLY JANE CUMMINGSCredential: M.D.
Location Address525 EAST 68TH STREET, PAYSON 2New York, NY 10065
Mailing Address525 E 68th St # 39New York, NY 10065-4870 · (212) 746-4888 · Fax (646) 697-0029
Sole ProprietorNo
Medical School CMSState University Of Ny Upstate Medical UniversityGraduated 2015
Enumeration DateApril 10, 2015
Last NPPES UpdateOctober 19, 2020
NPPES CertifiedOctober 19, 2020
NPI 1104212604 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in NY · 294062
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.

525 EAST 68TH STREET, New York, NY 10065

Secondary Practice Location 1

Location 1Dept Of Medicine Hsc Level 16, SUNY Stony Brook HospitalStony Brook, NY 11794-0001 · Phone (631) 444-2058 · Fax (631) 444-2493

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. Kelly Jane Cummings 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 ID5193069037
PECOS Enrollment IDI20200218001534
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 9

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 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.
605 services193 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.
109 services58 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.
100 services59 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
90 services88 patients
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.
77 services45 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.
14 services14 patients

Hospital Affiliations CMS Care Compare 2

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

New York-Presbyterian Hospital

Acute Care Hospitals · New York, NY
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330101
Location525 East 68th StreetNew York, NY 10065 · New York County
Emergency services Birthing friendly

Hospital For Special Surgery

Acute Care Hospitals · New York, NY
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330270
Location535 East 70th StreetNew York, NY 10021 · New York County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10065 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
$150.24 typical visit price
range $65.69 – $198.19
Typical copayment $37.56 (range $16.42 – $49.54)
Most-billed visit code 99204
Established Patient
$114.88 typical visit price
range $21.20 – $160.66
Typical copayment $28.72 (range $5.30 – $40.16)
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 through an Alternative Payment Model
Quality86.8
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 4

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

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
1 supplier34 claims34 services$36.21 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
1 supplier13 claims13 services$67.84 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
1 supplier16 claims16 services$13.36 avg. paid by Medicare
Lightweight wheelchair K0003
DME-Wheelchairs · category DD000N
1 supplier18 claims18 services$16.97 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.

Emergency Medicine
525 EAST 68TH STREET, EMERGENCY DEPARTMENT
NEW YORK, NY 10065
Dietitian, Registered
525 EAST 68TH STREET
NEW YORK, NY 10065
Radiology (Neuroradiology)
525 EAST 68TH STREET, STARR 8A
NEW YORK, NY 10065
Pediatrics (Pediatric Hematology-Oncology)
525 EAST 68TH STREET, NEW YORK- PRESBYTERIAN HOSPITAL - BOX 139
NEW YORK, NY 10065
Pediatrics (Neonatal-Perinatal Medicine)
525 EAST 68TH STREET, N506
NEW YORK, NY 10065
Radiology (Diagnostic Radiology)
525 EAST 68TH STREET, BOX 141 - RADIOLOGY DEPARTMENT
NEW YORK, NY 10065
Pathology (Cytopathology)
525 EAST 68TH STREET, F-766B
NEW YORK, NY 10065
Clinic/Center (Radiology)
525 EAST 68TH STREET, BOX 141
NEW YORK, NY 10065

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 Kelly Cummings's NPI number?

The NPI number for Kelly Cummings is 1104212604. It was assigned to this individual provider in the NPPES registry on April 10, 2015.

Where is Kelly Cummings located?

Kelly Cummings practices at 525 East 68th Street Payson 2, New York, NY 10065. The listed phone number is (212) 746-7000.

What is Kelly Cummings's specialty?

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

Is Kelly Cummings enrolled in Medicare?

Yes. Kelly Cummings 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.

Is Kelly Cummings affiliated with any hospitals?

According to CMS data, Kelly Cummings is affiliated with New York-Presbyterian Hospital and Hospital For Special Surgery.

When was this NPI record last updated?

The NPPES record for Kelly Cummings was last updated on October 19, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.