DR. BABU SHIVA KUMAR MD
NPI 1295721942
Internal Medicine in Hamden, CT

Active since September 27, 2005PECOS EnrolledAccepts Medicare Assignment
94.17/100
CMS Quality Rating
2543 DIXWELL AVE, HAMDEN, CT 06514(203) 230-4160(203) 848-2484 Get Directions Write a Review

NPPES record last updated: July 5, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Babu Shiva Kumar Md NPPES

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

DR. BABU SHIVA KUMAR MD (NPI 1295721942) is an individual internal medicine provider in Hamden, Connecticut, licensed in Connecticut (032892) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS and is a graduate of Other (1982).

NPPES Registry Identity

NPI1295721942
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. BABU SHIVA KUMARCredential: MD
Location Address2543 DIXWELL AVEHamden, CT 06514-1809
Mailing Address2543 Dixwell AveHamden, CT 06514-1809 · (203) 230-4160 · Fax (203) 848-2484
Fax(203) 848-2484
Sole ProprietorNo
Medical School CMSOtherGraduated 1982
Enumeration DateSeptember 27, 2005
Last NPPES UpdateJuly 5, 2013
NPI 1295721942 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in CT · 032892
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.

2543 DIXWELL AVE, Hamden, CT 06514

Other Identifiers 3

Medicaid001328922CT
Medicare PIN110010459CT
Medicare UPINF62278

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. Babu Shiva 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 ID3476442781
PECOS Enrollment IDI20080103000546
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 16

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.
613 services315 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.
501 services256 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.
156 services156 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
147 services147 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.
124 services124 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
58 services52 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06514 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
$138.84 typical visit price
range $60.82 – $183.10
Typical copayment $34.71 (range $15.20 – $45.77)
Most-billed visit code 99204
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
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.

94.17/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality81.94
Promoting Interoperability99.39
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 8

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
17 suppliers68 claims151 services$6.14 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
15 suppliers51 claims59 services$1.08 avg. paid by Medicare
Tracheal suction catheter, any type other than closed system, each A4624
DME-Other DME · category DE000N
1 supplier13 claims864 services$2.53 avg. paid by Medicare
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035
Other-Enteral and Parenteral · category OB006N
1 supplier15 claims393 services$4.14 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 supplier11 claims6,901 services$0.27 avg. paid by Medicare
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each E0955
DME-Wheelchairs · category DD021N
1 supplier12 claims12 services$13.34 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 6

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

Physician Assistant (Medical)
2543 DIXWELL AVE
HAMDEN, CT 06514
Physician Assistant (Medical)
2543 DIXWELL AVE
HAMDEN, CT 06514
Internal Medicine
2543 DIXWELL AVE
HAMDEN, CT 06514
Internal Medicine
2543 DIXWELL AVE
HAMDEN, CT 06514
Internal Medicine
2543 DIXWELL AVE
HAMDEN, CT 06514
Nurse Practitioner
2543 DIXWELL AVE
HAMDEN, CT 06514

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 Babu Kumar's NPI number?

The NPI number for Babu Kumar is 1295721942. It was assigned to this individual provider in the NPPES registry on September 27, 2005.

Where is Babu Kumar located?

Babu Kumar practices at 2543 Dixwell Ave, Hamden, CT 06514. The listed phone number is (203) 230-4160.

What is Babu Kumar's specialty?

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

Is Babu Kumar enrolled in Medicare?

Yes. Babu 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.

When was this NPI record last updated?

The NPPES record for Babu Kumar was last updated on July 5, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.