DR. SHANTHA KUMAR M.D.
NPI 1396768958
Internal Medicine - Cardiovascular Disease in Apache Junction, AZ
About Dr. Shantha Kumar M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. SHANTHA KUMAR M.D. (NPI 1396768958) is an individual cardiovascular disease provider in Apache Junction, Arizona, licensed in Arizona (23951) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in Mesa, and is a graduate of Other (1987).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Other Identifiers 2
Accepted 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
Dr. Shantha Kumar M.d. 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.
Medicare Billing Reassignments
3Medicare enrollment records show Shantha Kumar reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Mesa, AZ 85209
- Reassigned Medicare billing, Arizona enrollment
- 5 clinicians in this Medicare group
Mesa, AZ 85205
- Reassigned Medicare billing, Arizona enrollment
- 4 clinicians in this Medicare group
Mesa, AZ 85209
- Reassigned Medicare billing, Arizona enrollment
- 4 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 66
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 85120 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
Reported Quality Measures
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Shantha Kumar's NPI number?
The NPI number for Shantha Kumar is 1396768958. It was assigned to this individual provider in the NPPES registry on July 25, 2006.
Where is Shantha Kumar located?
Shantha Kumar practices at 99 S Gold Dr, Apache Junction, AZ 85120. The listed phone number is (480) 962-0101.
What is Shantha Kumar's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.
Is Shantha Kumar enrolled in Medicare?
Yes. Shantha 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 organizations bill Medicare for Shantha Kumar's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shantha Kumar reassigns Medicare benefits to 3 organizations: Goldfield Medical Clinics, LLC (Mesa, AZ), Clear Choice Physicians, LLC (Mesa, AZ) and Evolution Healthcare Management LLC (Mesa, AZ). Each 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 Shantha Kumar's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Shantha Kumar accept?
Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Cigna HealthCare of Arizona, Inc and Oscar Health Plan, Inc. and 1 other insurer list Shantha 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 Shantha Kumar was last updated on April 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.