RASHMI KUMAR MD
NPI 1396007068
Internal Medicine - Gastroenterology in Irvine, CA

Active since June 08, 2012PECOS EnrolledAccepts Medicare Assignment
84.41/100
CMS Quality Rating
16405 SAND CANYON AVE STE 280, IRVINE, CA 92618(949) 557-0251 Get Directions Write a Review

NPPES record last updated: February 27, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Rashmi Kumar Md NPPES

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

RASHMI KUMAR MD (NPI 1396007068) is an individual gastroenterology provider in Irvine, California, licensed in California (A137822) and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS, maintains a secondary practice location in Phoenix, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1396007068
Entity TypeIndividualFemale
Primary Taxonomy207RG0100X
Provider Legal NameRASHMI KUMARCredential: MD
Location Address16405 SAND CANYON AVE STE 280Irvine, CA 92618-3792
Mailing Address16405 Sand Canyon Ave Ste 280Irvine, CA 92618-3792 · (949) 557-0251
Sole ProprietorYes
Medical School CMSOtherGraduated 2007
Enumeration DateJune 8, 2012
Last NPPES UpdateFebruary 27, 2024
NPPES CertifiedFebruary 27, 2024
NPI 1396007068 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Licenses Licensed in CA · A137822 Licensed in AZ · 56483
Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Also ListedInternal MedicineTaxonomy 207R00000X · License R73466 (AZ)
16405 SAND CANYON AVE STE 280, Irvine, CA 92618

Secondary Practice Location 1

Location 11441 N 12th St Fl 2Phoenix, AZ 85006-2837 · Phone (602) 521-5180

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

Rashmi 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 ID941579528
PECOS Enrollment IDI20230918002469
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 9

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 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.
52 services33 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.
36 services23 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
32 services32 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
29 services29 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.
20 services20 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.
19 services19 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92618 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
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
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.

84.41/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality90.67
Promoting Interoperability100
Improvement Activities40
Cost57.36

Other Providers at the Same Location NPPES 3

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

Internal Medicine (Transplant Hepatology)
16405 SAND CANYON AVE STE 280
IRVINE, CA 92618
Colon & Rectal Surgery
16405 SAND CANYON AVE STE 280
IRVINE, CA 92618
Colon & Rectal Surgery
16405 SAND CANYON AVE STE 280
IRVINE, CA 92618

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 Rashmi Kumar's NPI number?

The NPI number for Rashmi Kumar is 1396007068. It was assigned to this individual provider in the NPPES registry on June 8, 2012.

Where is Rashmi Kumar located?

Rashmi Kumar practices at 16405 Sand Canyon Ave Ste 280, Irvine, CA 92618. The listed phone number is (949) 557-0251.

What is Rashmi Kumar's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Rashmi Kumar enrolled in Medicare?

Yes. Rashmi 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 Rashmi Kumar accept?

Health plans from Blue Cross Blue Shield of Arizona list Rashmi 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.

When was this NPI record last updated?

The NPPES record for Rashmi Kumar was last updated on February 27, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.