DR. NAVEEN KUMAR D.O.
NPI 1306038450
Otolaryngology - Otolaryngology/Facial Plastic Surgery in Gilbert, AZ
NPI Status: Active since August 13, 2007
Contact Information
3485 S MERCY RD
SUITE 104
GILBERT, AZ
ZIP 85297
Phone: (480) 558-3223
Fax: (480) 558-5152
- Individual
- Male
- Years of Experience 19
- Otolaryngology
- Otolaryngology/Facial Plastic Surgery
- Accepts Insurance
- May Accept Medicare Approved Payment
- PECOS Enrolled
About NAVEEN KUMAR
This page provides the complete NPI Profile along with additional information for Naveen Kumar, a provider established in Gilbert, Arizona with a medical specialization in Otolaryngology, focusing in otolaryngology/facial plastic surgery and more than 19 years of experience. He graduated from Lake Erie College Of Osteopathic Medicine, Erie in 2007. The healthcare provider is registered in the NPI registry with number 1306038450 assigned on August 2007. The practitioner's primary taxonomy code is 207YX0905X with license number 5101018000 (MI). The provider is registered as an individual and his NPI record was last updated 9 years ago.
- NPI
- 1306038450
- Provider Name
- DR. NAVEEN KUMAR D.O.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 3485 S MERCY RD SUITE 104 GILBERT, AZ 85297
- Location Phone
- (480) 558-3223
- Location Fax
- (480) 558-5152
- Mailing Address
- 3485 S MERCY RD SUITE 104 GILBERT, AZ 85297
- Mailing Phone
- (480) 558-3223
- Mailing Fax
- (480) 558-5152
- Medical School Name
- LAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
- Graduation Year
- 2007
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 08-13-2007
- Last Update Date
- 01-10-2017
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Otolaryngology Otolaryngology/Facial Plastic Surgery
- Taxonomy Code
- 207YX0905X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 5101018000
- License State
- MI
- Taxonomy Description
- An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
- UHC Bronze Essential ($0 Virtual Urgent Care) - HMO
- UHC Bronze Standard - HMO
- UHC Bronze Standard+ (Dental + Vision) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Gold Standard - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $8 Tier 2 Rx) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision) - HMO
- UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
- UHC Silver Standard - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Naveen Kumar is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.
Naveen Kumar is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 8820372758
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20170418002805
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Maybe
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Biopsy or removal of nasal polyp or tissue using an endoscope
Ct scan of face without contrast
Diagnostic exam of nasal passages using an endoscope
Diagnostic exam of voice box using a flexible endoscope
Dilation of nasal sinus using an endoscope
Dilation of sphenoid and frontal nasal sinus using an endoscope
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Insertion of hypoglossal nerve neurostimulator electrode and generator and breathing sensor electrode
New patient office or other outpatient visit, 30-44 minutes
New patient office or other outpatient visit, 45-59 minutes
Removal of impacted ear wax
Removal of nasal air passage under lining tissue
Removal or destruction of growth of nose through nose
A nasal biopsy or polyp removal is a procedure where an endoscope, a thin tube with a light and camera, is inserted into the nose. This allows the doctor to see and remove abnormal tissues or polyps, which are small growths. This procedure helps diagnose or treat nasal issues.
This service was performed 58 times for 44 patientsA CT scan of the face without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed pictures of your face, including bones, soft tissues, and blood vessels. It's often used to diagnose diseases, injuries, or abnormalities. No contrast dye is used in this procedure.
This service was performed 136 times for 128 patientsA diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
This service was performed 211 times for 140 patientsThis procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
This service was performed 60 times for 50 patientsDilation of the nasal sinus using an endoscope is a procedure to improve sinus drainage. A small tube with a camera, called an endoscope, is inserted into the nose. A balloon is then inflated to widen the sinus openings. This helps to relieve sinus pressure and symptoms.
This service was performed 51 times for 48 patientsThis procedure involves enlarging the openings of your sphenoid and frontal nasal sinuses using a thin, lighted tube called an endoscope. It helps to alleviate symptoms of sinusitis, improving your breathing and reducing discomfort.
This service was performed 52 times for 50 patientsThis 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.
This service was performed 41 times for 34 patientsThis 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.
This service was performed 156 times for 82 patientsThis procedure involves placing a device that stimulates the hypoglossal nerve, which controls tongue movement. A generator powers the device and a sensor monitors your breathing. This helps keep the airway open during sleep, improving conditions like sleep apnea.
This service was performed 12 times for 12 patientsThis 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.
This service was performed 83 times for 82 patientsThis 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.
This service was performed 96 times for 96 patientsImpacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
This service was performed 48 times for 35 patientsThis procedure, often done to improve breathing or address sinus issues, involves the removal of tissue from the lining of the nasal air passage. It's performed under anesthesia and recovery time varies based on individual health status.
This service was performed 49 times for 48 patientsThis procedure involves removing or destroying a growth in the nose. It's done through the nostrils, so no external cuts are made. The growth could be a polyp, cyst, or other abnormal tissue. It helps improve breathing and reduces discomfort or other symptoms caused by the growth.
This service was performed 33 times for 17 patientsReviews for DR. NAVEEN KUMAR D.O.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1306038450, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 50. The final step is to find the difference between that total and the next multiple of ten (50 - 50 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 50 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 7 providers are registered at the same or a nearby location.
GILBERT, AZ 85297
GILBERT, AZ 85297
GILBERT, AZ 85297
GILBERT, AZ 85297
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1306038450, enumerated as an "individual" on August 13, 2007.
The provider is located at 3485 S MERCY RD SUITE 104 GILBERT, AZ 85297 and the phone number is (480) 558-3223.
Otolaryngology with taxonomy code 207YX0905X and a focus in Otolaryngology/Facial Plastic Surgery.
The provider might be accepting Accepts: UnitedHealthcare. Please consult your insurance carrier or call the provider to verify.