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SUNIL KUMAR
NPI 1164042016
Internal Medicine in Peoria, IL

Active since April 21, 2020PECOS EnrolledAccepts Medicare Assignment
530 NE GLEN OAK AVE # AHS, PEORIA, IL 61637(309) 655-2000 Get Directions Write a Review

NPPES record last updated: October 5, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 5, 2023, Apr 21, 2020 (2 updates tracked since 2020).

About Sunil Kumar NPPES

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

SUNIL KUMAR (NPI 1164042016) is an individual internal medicine provider in Peoria, Illinois, licensed in Illinois (036.164782) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS, is affiliated with St Mary Medical Center, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1164042016
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameSUNIL KUMAR
Location Address530 NE GLEN OAK AVE # AHSPeoria, IL 61637-0001
Mailing AddressOsf Healthcare- Saint Francis Medical Center 530 Ne GlPeoria, IL 61637-0001 · (309) 655-2000
Phone(309) 655-2000
Sole ProprietorNo
Medical School CMSOtherGraduated 1998
Enumeration DateApril 21, 2020
Last NPPES UpdateOctober 5, 20232 updates tracked since enumeration
NPPES CertifiedOctober 5, 2023
✔ NPI 1164042016 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 036.164782
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License TL0008353 (CO)
530 NE GLEN OAK AVE # AHS, Peoria, IL 61637
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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

Sunil Kumar 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 ID7012333925
PECOS Enrollment IDI20230612002744
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 4

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.
586 services229 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.
213 services205 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.
154 services149 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.
112 services63 patients

Hospital Affiliations CMS Care Compare 2

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

St Mary Medical Center

Acute Care Hospitals · Galesburg, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140064
Location3333 North SeminaryGalesburg, IL 61401 · Knox County
Emergency services Birthing friendly

Saint Francis Medical Center

Acute Care Hospitals · Peoria, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140067
Location530 NE Glen Oak AvePeoria, IL 61637 · Peoria County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61637 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
$127.46 typical visit price
range $54.80 – $168.44
Typical copayment $31.86 (range $13.70 – $42.11)
Most-billed visit code 99204
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

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 Sunil Kumar's NPI number?

The NPI number for Sunil Kumar is 1164042016. It was assigned to this individual provider in the NPPES registry on April 21, 2020.

Where is Sunil Kumar located?

Sunil Kumar practices at 530 NE Glen Oak Ave # Ahs, Peoria, IL 61637. The listed phone number is (309) 655-2000.

What is Sunil Kumar's specialty?

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

Is Sunil Kumar enrolled in Medicare?

Yes. Sunil 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 Sunil Kumar affiliated with any hospitals?

According to CMS data, Sunil Kumar is affiliated with St Mary Medical Center and Saint Francis Medical Center.

When was this NPI record last updated?

The NPPES record for Sunil Kumar was last updated on October 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.