DR. KAPISTHALAM S KUMAR MD
NPI 1255335758
Internal Medicine - Medical Oncology in Trinity, FL

Active since June 13, 2005PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
9320 STATE ROAD 54, TRINITY, FL 34655(727) 493-2513(727) 842-8676 Get Directions Write a Review

NPPES record last updated: August 10, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 10, 2022, Nov 15, 2021, Feb 10, 2016 (3 updates tracked since 2016).

About Dr. Kapisthalam S Kumar Md NPPES

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

DR. KAPISTHALAM S KUMAR MD (NPI 1255335758) is an individual medical oncology provider in Trinity, Florida, licensed in Florida (67089) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with Morton Plant North Bay Hospital, and is a graduate of Other (1975).

NPPES Registry Identity

NPI1255335758
Entity TypeIndividualMale
Primary Taxonomy207RX0202X
Provider Legal NameDR. KAPISTHALAM S KUMARCredential: MD
Location Address9320 STATE ROAD 54Trinity, FL 34655-1808
Mailing AddressPo Box 102222, Attn: CredentialingAtlanta, GA 30368-2222 · (239) 274-8200 · Fax (239) 278-3350
Fax(727) 842-8676
Sole ProprietorNo
Medical School CMSOtherGraduated 1975
Enumeration DateJune 13, 2005
Last NPPES UpdateAugust 10, 20223 updates tracked since enumeration
NPPES CertifiedAugust 10, 2022
NPI 1255335758 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Medical OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RX0202X
License Licensed in FL · 67089
Definition
An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer.
Also ListedInternal Medicine · HematologyTaxonomy 207RH0000X · License 67089 (FL)
9320 STATE ROAD 54, Trinity, FL 34655

Other Identifiers 7

Other5476991001Cigna
Other4129445Aetna
Other110000805FL · Rail Road Medicare
Other211275Avmed
Other0055468FL · Ghi
Medicaid062866200FL
Other51147FL · Bc/bs

Accepted 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. Kapisthalam S 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 ID3870553670
PECOS Enrollment IDI20100209000244
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 33

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.

Injection, ferumoxytol, for treatment of iron deficiency anemia, 1 mg (non-esrd use) Q0138
Ferumoxytol injection is a treatment for iron deficiency anemia, a condition where your body lacks enough iron. It is injected into your vein to increase iron levels, aiding in the production of healthy red blood cells. This treatment is not for ESRD patients.
32,640 services31 patients
Injection, denosumab, 1 mg J0897
Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.
2,880 services17 patients
Injection, epoetin alfa, (for non-esrd use), 1000 units J0885
Epoetin alfa is a medication injected to help your body produce more red blood cells, improving energy levels and reducing tiredness. It's often used for patients with certain types of anemia. Each injection contains 1000 units of the medicine.
2,740 services17 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
1,478 services353 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.
1,427 services360 patients
Injection, ondansetron hydrochloride, per 1 mg J2405
Ondansetron hydrochloride is a medication given via injection to help prevent nausea and vomiting, often due to chemotherapy or surgery. It works by blocking certain chemicals in the body that trigger these symptoms.
1,264 services14 patients

Hospital Affiliations CMS Care Compare 3

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

Morton Plant North Bay Hospital

Acute Care Hospitals · New Port Richey, FL
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100063
Location6600 Madison StNew Port Richey, FL 34652 · Pasco County
Emergency services

Hca Florida Trinity Hospital

Acute Care Hospitals · Trinity, FL
3/5 CMS rating
OwnershipProprietary
CMS Certification Number100191
Location9330 Sr 54Trinity, FL 34655 · Pasco County
Emergency services Birthing friendly

Hca Florida Bayonet Point Hospital

Acute Care Hospitals · Hudson, FL
2/5 CMS rating
OwnershipProprietary
CMS Certification Number100256
Location14000 Fivay RdHudson, FL 34667 · Pasco County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34655 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
$171.84 typical visit price
range $56.00 – $171.84
Typical copayment $42.96 (range $14.00 – $42.96)
Most-billed visit code 99205
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

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.
92%2,151 patients4/55-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…
60%173 patients3/55-star benchmark: 96%
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.
99%198 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.
33%886 patients2/55-star benchmark: 99%
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…
82%886 patients4/55-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…
1%886 patients1/55-star benchmark: 59%
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 2

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

Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034
Other-Enteral and Parenteral · category OB006N
1 supplier12 claims372 services$2.70 avg. paid by Medicare
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152
Other-Enteral and Parenteral · category OB006N
1 supplier12 claims6,600 services$0.26 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.

Internal Medicine (Medical Oncology)
9320 STATE ROAD 54
TRINITY, FL 34655
Nurse Practitioner (Gerontology)
9320 STATE ROAD 54
TRINITY, FL 34655
Nurse Practitioner (Family)
9320 STATE ROAD 54
TRINITY, FL 34655
Nurse Practitioner (Gerontology)
9320 STATE ROAD 54
TRINITY, FL 34655
Physician Assistant
9320 STATE ROAD 54
TRINITY, FL 34655
Nurse Practitioner
9320 STATE ROAD 54
TRINITY, FL 34655
Nurse Practitioner (Family)
9320 STATE ROAD 54
TRINITY, FL 34655
Nurse Practitioner (Gerontology)
9320 STATE ROAD 54
TRINITY, FL 34655

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 Kapisthalam Kumar's NPI number?

The NPI number for Kapisthalam Kumar is 1255335758. It was assigned to this individual provider in the NPPES registry on June 13, 2005.

Where is Kapisthalam Kumar located?

Kapisthalam Kumar practices at 9320 State Road 54, Trinity, FL 34655. The listed phone number is (727) 493-2513.

What is Kapisthalam Kumar's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Medical Oncology, with taxonomy code 207RX0202X.

Is Kapisthalam Kumar enrolled in Medicare?

Yes. Kapisthalam 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 Kapisthalam Kumar accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, AvMed and Florida Blue (BlueCross BlueShield FL) and 5 other insurers list Kapisthalam 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 Kapisthalam Kumar affiliated with any hospitals?

According to CMS data, Kapisthalam Kumar is affiliated with Morton Plant North Bay Hospital, Hca Florida Trinity Hospital and Hca Florida Bayonet Point Hospital.

When was this NPI record last updated?

The NPPES record for Kapisthalam Kumar was last updated on August 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.