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DR. RADHA KUMAR MD
NPI 1174539373
Internal Medicine in Edison, NJ

Active since July 31, 2006PECOS EnrolledAccepts Medicare Assignment
34-36 PROGRESS ST, SUITE A-2, EDISON, NJ 08820(908) 226-0600(908) 226-1802 Get Directions Write a Review

NPPES record last updated: November 20, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Radha Kumar Md NPPES

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

DR. RADHA KUMAR MD (NPI 1174539373) is an individual internal medicine provider in Edison, New Jersey, licensed in New Jersey (MA66863) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS, is affiliated with Jfk Medical Center, and is a graduate of Other (1989).

NPPES Registry Identity

NPI1174539373
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. RADHA KUMARCredential: MD
Location Address34-36 PROGRESS ST, SUITE A-2Edison, NJ 08820-1197
Mailing Address34-36 Progress St, Suite A-2Edison, NJ 08820-1197 · (908) 226-0600 · Fax (908) 226-1802
Phone(908) 226-0600
Fax(908) 226-1802
Sole ProprietorYes
Medical School CMSOtherGraduated 1989
Enumeration DateJuly 31, 2006
Last NPPES UpdateNovember 20, 2012
✔ NPI 1174539373 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in NJ · MA66863✔ Licensed in NY · 207027
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.
34-36 PROGRESS ST, Edison, NJ 08820
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Other Names 1

Former Name (1)Radha Raju Md

Other Identifiers 2

Medicare ID-Type Unspecified031666NJ
Medicare UPING56002NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include 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. Radha 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 ID8628240850
PECOS Enrollment IDI20111013000092
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 11

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.
180 services85 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.
176 services76 patients
Assessment of emotional or behavioral problems 96127
Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.
172 services38 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.
116 services54 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
65 services64 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.
60 services60 patients

Hospital Affiliations CMS Care Compare

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

Jfk Medical Center

Acute Care Hospitals · Edison, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310108
Location65 James StreetEdison, NJ 08820 · Middlesex County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08820 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
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
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.

Reported Quality Measures

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.
100%12,528 patients5/55-star benchmark: 100%
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.
97%29 patients4/55-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.
77%1,531 patients4/55-star benchmark: 100%
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…
34%1,531 patients2/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
21%1,531 patients2/55-star benchmark: 79%
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

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
6 suppliers13 claims25 services$5.12 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 9

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

RICHARD A GAN MD
Psychiatry & Neurology (Neurology)
34-36 PROGRESS ST, B-3
EDISON, NJ 08820
Middlesex County (908) 757-6633
EDISON FAMILY DENTAL CARE L.L.C
Dentist (General Practice)
34-36 PROGRESS ST, SUITE B-6
EDISON, NJ 08820
Middlesex County (908) 757-5559
DR. ERIC DAITER M.D.
Obstetrics & Gynecology (Reproductive Endocrinology)
34-36 PROGRESS ST, SUITE B4
EDISON, NJ 08820
Middlesex County (908) 226-0250
EDISON NEUROLOGIC ASSOCIATES
Psychiatry & Neurology (Neurology)
34-36 PROGRESS ST, SUITE B-3
EDISON, NJ 08820
Middlesex County (908) 757-6633
DIAMOND BRACES EDISON
Dentist (Orthodontics and Dentofacial Orthopedics)
34-36 PROGRESS ST, SUITE A4
EDISON, NJ 08820
Middlesex County (908) 222-8228
REGIONAL CANCER CARE ASSOCIATES LLC
Internal Medicine (Hematology & Oncology)
34-36 PROGRESS ST, SUITE B-2
EDISON, NJ 08820
Middlesex County (908) 757-9696
DR. ROBERT CZYZEWSKI M.D.
Internal Medicine (Nephrology)
34-36 PROGRESS ST, SUITE A-7
EDISON, NJ 08820
Middlesex County (908) 769-1440
DR. ATUL V PATEL MD
Obstetrics & Gynecology
34-36 PROGRESS ST, ST # A6
EDISON, NJ 08820
Middlesex County (908) 757-9555

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 Radha Kumar's NPI number?

The NPI number for Radha Kumar is 1174539373. It was assigned to this individual provider in the NPPES registry on July 31, 2006. The provider is also known as Radha Raju MD.

Where is Radha Kumar located?

Radha Kumar practices at 34-36 Progress St Suite A-2, Edison, NJ 08820. The listed phone number is (908) 226-0600.

What is Radha Kumar's specialty?

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

Is Radha Kumar enrolled in Medicare?

Yes. Radha 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 Radha Kumar accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Radha 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 Radha Kumar affiliated with any hospitals?

According to CMS data, Radha Kumar is affiliated with Jfk Medical Center.

When was this NPI record last updated?

The NPPES record for Radha Kumar was last updated on November 20, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.