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SHALINI KUMAR MD
NPI 1255909479
Family Medicine in Plainfield, IL

Active since June 14, 2021PECOS EnrolledAccepts Medicare Assignment
16519 S ROUTE 59, PLAINFIELD, IL 60586(630) 646-5020(630) 646-5025 Get Directions Write a Review

NPPES record last updated: August 8, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 8, 2025, Apr 29, 2022, Jun 14, 2021 (3 updates tracked since 2021).

About Shalini Kumar Md NPPES

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

SHALINI KUMAR MD (NPI 1255909479) is an individual family medicine provider in Plainfield, Illinois, licensed in Illinois (036173707) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS, is affiliated with Edward Hospital, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1255909479
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameSHALINI KUMARCredential: MD
Location Address16519 S ROUTE 59Plainfield, IL 60586-2607
Mailing Address2650 Ridge Ave Ste 1223Evanston, IL 60201-1700 · (847) 570-2040
Phone(630) 646-5020
Fax(630) 646-5025
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateJune 14, 2021
Last NPPES UpdateAugust 8, 20253 updates tracked since enumeration
NPPES CertifiedAugust 8, 2025
✔ NPI 1255909479 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 036173707
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
16519 S ROUTE 59, Plainfield, IL 60586
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shalini 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 ID8527586817
PECOS Enrollment IDI20250520002408
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.

Medicare Billing Reassignment

Medicare enrollment records show Shalini Kumar reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Endeavor Health Medical Group
43 mi
Allergy & Immunology
1000 CENTRAL ST
Evanston, IL 60201
  • Reassigned Medicare billing, Illinois enrollment
  • 4,841 clinicians in this Medicare group
NPI 1497701882 (847) 570-5235

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

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

Edward Hospital

Acute Care Hospitals · Naperville, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140231
Location801 South WashingtonNaperville, IL 60540 · Du Page County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60586 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
$93.02 typical visit price
range $59.81 – $181.38
Typical copayment $23.25 (range $14.95 – $45.34)
Most-billed visit code 99203
Established Patient
$105.07 typical visit price
range $19.15 – $147.12
Typical copayment $26.26 (range $4.78 – $36.78)
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.

Other Providers at the Same Location NPPES 7

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

DANIELLE MARIE EVERETT PA-C
Physician Assistant
16519 S ROUTE 59
PLAINFIELD, IL 60586
Will County (630) 870-7310
CAITLIN CHENEY APN-CNP
Nurse Practitioner
16519 S ROUTE 59
PLAINFIELD, IL 60586
Will County (630) 646-5172
PHAMELA B. DE GUZMAN MD
Family Medicine
16519 S ROUTE 59
PLAINFIELD, IL 60586
Will County (630) 646-5020
EDWARD HEALTH VENTURES
Family Medicine
16519 S ROUTE 59
PLAINFIELD, IL 60586
Will County (630) 646-5020
GINA T GEDUTIS APRN, FNP-C
Nurse Practitioner
16519 S ROUTE 59
PLAINFIELD, IL 60586
Will County (630) 646-5020
DR. ARPIT DEVENDRA PATEL M.D.
Family Medicine
16519 S ROUTE 59
PLAINFIELD, IL 60586
Will County (630) 527-3200
MRS. ELIZABETH AIMEE LAYFIELD PA-C
Physician Assistant
16519 S ROUTE 59
PLAINFIELD, IL 60586
Will County (630) 646-5020

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 Shalini Kumar's NPI number?

The NPI number for Shalini Kumar is 1255909479. It was assigned to this individual provider in the NPPES registry on June 14, 2021.

Where is Shalini Kumar located?

Shalini Kumar practices at 16519 S Route 59, Plainfield, IL 60586. The listed phone number is (630) 646-5020.

What is Shalini Kumar's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Shalini Kumar enrolled in Medicare?

Yes. Shalini 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.

Which organization bills Medicare for Shalini Kumar's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shalini Kumar reassigns Medicare benefits to Endeavor Health Medical Group (Evanston, IL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shalini Kumar's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shalini Kumar accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Oscar Health list Shalini 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 Shalini Kumar affiliated with any hospitals?

According to CMS data, Shalini Kumar is affiliated with Edward Hospital.

When was this NPI record last updated?

The NPPES record for Shalini Kumar was last updated on August 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.