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DR. PREM KUMAR M.D.
NPI 1124003587
Internal Medicine in Valdosta, GA

Active since December 08, 2005PECOS EnrolledAccepts Medicare Assignment
90.48/100
CMS Quality Rating
3300 GREYSTONE WAY, VALDOSTA, GA 31605(229) 247-7700(229) 247-2666 Get Directions Write a Review

NPPES record last updated: March 20, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Prem Kumar M.d. NPPES

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

DR. PREM KUMAR M.D. (NPI 1124003587) is an individual internal medicine provider in Valdosta, Georgia, licensed in Georgia (466691) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with Northside Hospital, and is a graduate of Other (1984).

NPPES Registry Identity

NPI1124003587
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. PREM KUMARCredential: M.D.
Location Address3300 GREYSTONE WAYValdosta, GA 31605-1096
Mailing Address3300 Greystone WayValdosta, GA 31605-1096 · (229) 247-7700 · Fax (229) 247-2666
Phone(229) 247-7700
Fax(229) 247-2666
Sole ProprietorNo
Medical School CMSOtherGraduated 1984
Enumeration DateDecember 8, 2005
Last NPPES UpdateMarch 20, 2010
✔ NPI 1124003587 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in GA · 466691
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.
3300 GREYSTONE WAY, Valdosta, GA 31605
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Other Identifiers 3

Medicaid00814107IGA
Medicaid00814107JGA
Medicare UPING56102

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. Prem 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 ID2961421730
PECOS Enrollment IDI20051122000366
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 10

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 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.
369 services191 patients
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.
261 services187 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.
158 services158 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.
86 services48 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.
40 services33 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
38 services38 patients

Hospital Affiliations CMS Care Compare 2

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

Northside Hospital

Acute Care Hospitals · Atlanta, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110161
Location1000 Johnson Ferry Road, NEAtlanta, GA 30342 · Fulton County
Birthing friendly

Northside Hospital Duluth

Acute Care Hospitals · Duluth, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110252
Location3620 Howell Ferry RoadDuluth, GA 30096 · Gwinnett County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31605 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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.

90.48/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality74.5
Promoting Interoperability95.74
Improvement Activities40

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
68%334 patients3/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
68%649 patients4/55-star benchmark: 85%
Diabetes: Foot Exam
The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year
96%255 patients4/55-star benchmark: 98%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
99%4,413 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
0%25,327 patients1/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
3%32 patients1/55-star benchmark: 98%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%449 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
100%1,250 patients5/55-star benchmark: 100%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
67%880 patients4/55-star benchmark: 88%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
18%1,249 patients1/55-star benchmark: 100%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 398 patients
1%398 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 15

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
11 suppliers45 claims94 services$6.15 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
6 suppliers12 claims13 services$1.10 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
2 suppliers17 claims17 services$36.61 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
3 suppliers13 claims13 services$90.76 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
3 suppliers17 claims17 services$60.25 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
3 suppliers14 claims14 services$19.17 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

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

VALDOSTA MEDICAL ASSOCIATES
Internal Medicine
3300 GREYSTONE WAY
VALDOSTA, GA 31605
Lowndes County (229) 247-7700

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 Prem Kumar's NPI number?

The NPI number for Prem Kumar is 1124003587. It was assigned to this individual provider in the NPPES registry on December 8, 2005.

Where is Prem Kumar located?

Prem Kumar practices at 3300 Greystone Way, Valdosta, GA 31605. The listed phone number is (229) 247-7700.

What is Prem Kumar's specialty?

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

Is Prem Kumar enrolled in Medicare?

Yes. Prem 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.

Is Prem Kumar affiliated with any hospitals?

According to CMS data, Prem Kumar is affiliated with Northside Hospital and Northside Hospital Duluth.

When was this NPI record last updated?

The NPPES record for Prem Kumar was last updated on March 20, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.