PRIYANKA KUMAR
NPI 1295078418
Urology in East Chicago, IN

Q: What is Priyanka Kumar's NPI number?

The NPI number for Priyanka Kumar is 1295078418. It was assigned to this individual provider in the NPPES registry on April 6, 2013.

Q: What is Priyanka Kumar's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Priyanka Kumar was last updated on September 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.

Active since April 06, 2013PECOS EnrolledAccepts Medicare Assignment

4320 FIR STREET, SUITE 220, EAST CHICAGO, IN 46312(219) 703-2591 Get Directions Write a Review

NPPES record last updated: September 11, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 11, 2024, Sep 30, 2018 (2 updates tracked since 2018).

On this page

About Priyanka Kumar NPPES

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

PRIYANKA KUMAR (NPI 1295078418) is an individual urology provider in East Chicago, Indiana, licensed in Indiana (01080766A) and active in the NPI registry since April 2013. She is enrolled in Medicare PECOS, is affiliated with Methodist Hospitals Inc, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1295078418

Entity TypeIndividualFemale

Primary Taxonomy208800000X

Provider Legal NamePRIYANKA KUMAR

Location Address4320 FIR STREET, SUITE 220East Chicago, IN 46312

Mailing Address4320 Fir Street, Suite 220East Chicago, IN 46312 · (219) 703-2591

Phone(219) 703-2591

Sole ProprietorNo

Medical School CMSIndiana University School Of MedicineGraduated 2013

Enumeration DateApril 6, 2013

Last NPPES UpdateSeptember 11, 20242 updates tracked since enumeration

NPPES CertifiedSeptember 11, 2024

✔ NPI 1295078418 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in IN · 01080766A

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

4320 FIR STREET, East Chicago, IN 46312

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Secondary Practice Locations 3

Location 14201 Saint Antoine St, University Health Center 6CDetroit, MI 48201-2153 · Phone (313) 577-5009

Location 24320 Fir Street, Suite 220East Chicago, IN 46312 · Phone (219) 703-2591

Location 31104 E Grace StRensselaer, IN 47978-3211 · Phone (219) 866-2010 · Fax (219) 866-9893

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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

Priyanka 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 ID749582724

PECOS Enrollment IDI20181018000570

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 23

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, onabotulinumtoxina, 1 unit J0585

Onabotulinumtoxina, also known as Botox, is a medication injected into muscles. It's used to treat various conditions by blocking nerve activity in the muscles, causing a temporary reduction in muscle activity. The units refer to the dosage.

4,950 services32 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

1,142 services732 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

669 services498 patients

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.

558 services373 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.

489 services406 patients

Leuprolide acetate (for depot suspension), 7.5 mg J9217

Leuprolide acetate is a medication that helps regulate certain hormone levels in your body. It's injected into your muscle once a month. This treatment can help manage various health conditions related to hormone imbalance. Always follow your doctor's instructions.

192 services22 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

161 services161 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.

140 services108 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

131 services121 patients

Manual urinalysis test with examination using microscope, automated 81001

A manual urinalysis test with automated microscopic examination is a lab process that checks your urine for health indicators. It involves a machine scanning your sample to identify any abnormal elements, which can assist in diagnosing various conditions.

93 services84 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

67 services67 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.

60 services30 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

47 services43 patients

Exam with injections of chemical for destruction of bladder using an endoscope 52287

This procedure involves the use of a thin, flexible tube with a light (endoscope) for internal examination. A chemical is then injected to help eliminate specific issues in the bladder. It's a standard and safe process.

41 services32 patients

Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle 96402

This procedure involves the injection of hormone-based anti-cancer drugs under the skin or into a muscle. These medications help to slow down or stop the growth of certain types of cancer cells. The process is usually quick and can be performed in a clinic or hospital.

32 services22 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.

30 services30 patients

Imaging of urinary tract following injection of a contrast agent 74420

This procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.

23 services17 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

21 services21 patients

Insertion of stent in ureter using an endoscope 52332

This procedure involves placing a small, flexible tube (stent) in your body's drainage system to help urine flow from the kidneys to the bladder. An endoscope, a thin tube with a light and camera, is used for precise placement.

19 services18 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

19 services19 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

17 services16 patients

Injection of implant material beneath lining of bladder and/or urethra using an endoscope 51715

This is a procedure where a substance is inserted under the bladder or urethra lining using a special instrument called an endoscope. This helps to support these areas and improve their function. It's done in a safe, controlled medical environment.

16 services14 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

14 services14 patients

Hospital Affiliations CMS Care Compare 5

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

Methodist Hospitals Inc

Acute Care Hospitals · Gary, IN

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150002

Location600 Grant StGary, IN 46402 · Lake County

Emergency services Birthing friendly

St Mary Medical Center Inc

Acute Care Hospitals · Hobart, IN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150034

Location1500 S Lake Park AveHobart, IN 46342 · Lake County

Emergency services Birthing friendly

Community Hospital

Acute Care Hospitals · Munster, IN

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150125

Location901 Macarthur BlvdMunster, IN 46321 · Lake County

Emergency services Birthing friendly

Franciscan Health Crown Point

Acute Care Hospitals · Crown Point, IN

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number150126

Location12750 Saint Francis DriveCrown Point, IN 46307 · Lake County

Emergency services Birthing friendly

Franciscan Health Rensselaer, Inc

Critical Access Hospitals · Rensselaer, IN

OwnershipVoluntary non-profit - Private

CMS Certification Number151324

Location1104 E Grace StRensselaer, IN 47978 · Jasper County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46312 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

$122.49 typical visit price

range $53.07 – $161.76

Typical copayment $30.62 (range $13.26 – $40.44)

Most-billed visit code 99204

Established Patient

$66.48 typical visit price

range $16.93 – $132.22

Typical copayment $16.62 (range $4.23 – $33.05)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

3 suppliers28 claims5,497 services$1.42 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 4

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

JAIME E RUIZ MONTERO MD

Internal Medicine

4320 FIR STREET, SUITE 410
EAST CHICAGO, IN 46312

Lake County (219) 397-8965

GRACIELA E. HERNANDEZ MEDICAL CORPORATION P C

Clinic/Center (Mental Health (Including Community Mental Health Center))

4320 FIR STREET
EAST CHICAGO, IN 46312

Lake County (219) 397-2929

RALPH WILLIAM RICHTER JR. MD

Orthopaedic Surgery

4320 FIR STREET
EAST CHICAGO, IN 46312

Lake County (219) 392-1215

VIRGINIA ELIZABETH HYLAND MS, CNS

Clinical Nurse Specialist (Critical Care Medicine)

4320 FIR STREET, SUITE 320
EAST CHICAGO, IN 46312

Lake County (219) 554-4080

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 Priyanka Kumar's NPI number?

The NPI number for Priyanka Kumar is 1295078418. It was assigned to this individual provider in the NPPES registry on April 6, 2013.

Where is Priyanka Kumar located?

Priyanka Kumar practices at 4320 Fir Street Suite 220, East Chicago, IN 46312. The listed phone number is (219) 703-2591.

What is Priyanka Kumar's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Priyanka Kumar enrolled in Medicare?

Yes. Priyanka 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 Priyanka Kumar accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and CareSource list Priyanka 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 Priyanka Kumar affiliated with any hospitals?

According to CMS data, Priyanka Kumar is affiliated with Methodist Hospitals Inc, St Mary Medical Center Inc, Community Hospital, Franciscan Health Crown Point and Franciscan Health Rensselaer, Inc.

When was this NPI record last updated?

The NPPES record for Priyanka Kumar was last updated on September 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.