DR. PRASHANT KUMAR M.D.
NPI 1427087071
Specialist in Lufkin, TX

Q: What is Prashant Kumar's NPI number?

The NPI number for Prashant Kumar is 1427087071. It was assigned to this individual provider in the NPPES registry on July 3, 2006.

Q: What is Prashant Kumar's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Q: When was this NPI record last updated?

The NPPES record for Prashant Kumar was last updated on March 17, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.

Active since July 03, 2006PECOS EnrolledAccepts Medicare Assignment

95.99/100

CMS Quality Rating

409 GASLIGHT BLVD, LUFKIN, TX 75904(936) 634-2227(936) 634-4658 Get Directions Write a Review

NPPES record last updated: March 17, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Prashant Kumar M.d. NPPES

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

DR. PRASHANT KUMAR M.D. (NPI 1427087071) is an individual specialist in Lufkin, Texas, licensed in Texas (M2885) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Chi St Lukes Health Memorial Lufkin, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1427087071

Entity TypeIndividualMale

Primary Taxonomy174400000X

Provider Legal NameDR. PRASHANT KUMARCredential: M.D.

Location Address409 GASLIGHT BLVDLufkin, TX 75904-3132

Mailing AddressPo Box 150408Lufkin, TX 75915-0408 · (936) 634-2227 · Fax (936) 634-4658

Phone(936) 634-2227

Fax(936) 634-4658

Sole ProprietorNo

Medical School CMSOtherGraduated 1998

Enumeration DateJuly 3, 2006

Last NPPES UpdateMarch 17, 2011

✔ NPI 1427087071 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in TX · M2885

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

409 GASLIGHT BLVD, Lufkin, TX 75904

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Other Identifiers 2

Medicare UPINI59254TX

Other0041AHTX · Medicare Ptan

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, UnitedHealthcare.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. Prashant 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.

PECOS PAC ID7911902705

PECOS Enrollment IDI20060929000310

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.

Medicare Billing Reassignment

Medicare enrollment records show Prashant Kumar reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

E T Nephrology Associates PA

0.8 mi

Nephrology

1111 W FRANK AVE, SUITE 303
Lufkin, TX 75904

Reassigned Medicare billing, Texas enrollment
6 clinicians in this Medicare group

NPI 1427071406 (936) 634-2227

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 12

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.

632 services290 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.

300 services125 patients

Dialysis services, 4 or more physician visits per month (20 years or older) 90960

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.

199 services34 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

185 services104 patients

Dialysis services, 2-3 physician visits per month (20 years or older) 90961

Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.

84 services30 patients

Home dialysis services per month (20 years or older) 90966

Home dialysis services provide kidney treatment for patients aged 20 or older right in their own homes. This service includes necessary equipment, supplies, and support for performing dialysis. It's a convenient option that allows patients to maintain their daily routines while receiving essential care.

83 services12 patients

Hemodialysis procedure with physician evaluation 90935

Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.

62 services33 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.

55 services49 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.

43 services39 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.

38 services38 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.

38 services34 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

18 services12 patients

Hospital Affiliations CMS Care Compare 5

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

Chi St Lukes Health Memorial Lufkin

Acute Care Hospitals · Lufkin, TX

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450211

Location1201 West Frank StreetLufkin, TX 75901 · Angelina County

Emergency services Birthing friendly

Chi St Lukes Health Memorial Livingston

Acute Care Hospitals · Livingston, TX

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450395

Location1717 Hwy 59 BypassLivingston, TX 77351 · Polk County

Emergency services Birthing friendly

Tyler County Hospital

Acute Care Hospitals · Woodville, TX

OwnershipGovernment - Hospital District or Authority

CMS Certification Number450460

Location1100 West BluffWoodville, TX 75979 · Tyler County

Emergency services

Woodland Heights Medical Center

Acute Care Hospitals · Lufkin, TX

4/5 CMS rating

OwnershipProprietary

CMS Certification Number450484

Location505 South John Redditt DriveLufkin, TX 75904 · Angelina County

Emergency services Birthing friendly

Sabine County Hospital

Critical Access Hospitals · Hemphill, TX

OwnershipProprietary

CMS Certification Number451361

LocationPO Box 750, 2301 Hwy 83 WHemphill, TX 75948 · Sabine County

Emergency services

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.

95.99/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

100

Improvement Activities

Cost

63.98

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg J7503

Treatment-Chemotherapy · category RH002N

2 suppliers16 claims12,840 services$1.21 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

2 suppliers16 claims16 services$184.98 avg. paid by Medicare

Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512

Treatment-Chemotherapy · category RH012N

2 suppliers18 claims24 services$12.62 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 7

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

SSK PHYSICIAN ASSOCIATES

Internal Medicine (Rheumatology)

409 GASLIGHT BLVD
LUFKIN, TX 75904

Angelina County (936) 634-4422

SHALICIA RIGGINS APRN-CNP

Nurse Practitioner (Family)

409 GASLIGHT BLVD
LUFKIN, TX 75904

Angelina County (936) 634-4422

MR. IMRAN NAZEER M.D.

Specialist

409 GASLIGHT BLVD, SUITE 303
LUFKIN, TX 75904

Angelina County (936) 634-2227

DR. SWATI SHARMA KUMAR MBBS

Internal Medicine (Rheumatology)

409 GASLIGHT BLVD
LUFKIN, TX 75904

Angelina County (936) 634-4422

MRS. COURTNEY MICHELLE PHILLIPS FNP

Nurse Practitioner (Family)

409 GASLIGHT BLVD
LUFKIN, TX 75904

Angelina County (936) 634-4422

MRS. MARY LOUISE GREER FNP-C

Nurse Practitioner (Family)

409 GASLIGHT BLVD
LUFKIN, TX 75904

Angelina County (936) 634-2227

MUHAMMAD AMJAD MIR DO

Internal Medicine (Nephrology)

409 GASLIGHT BLVD
LUFKIN, TX 75904

Angelina County (936) 634-2227

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 Prashant Kumar's NPI number?

The NPI number for Prashant Kumar is 1427087071. It was assigned to this individual provider in the NPPES registry on July 3, 2006.

Where is Prashant Kumar located?

Prashant Kumar practices at 409 Gaslight Blvd, Lufkin, TX 75904. The listed phone number is (936) 634-2227.

What is Prashant Kumar's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Prashant Kumar enrolled in Medicare?

Yes. Prashant 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 organization bills Medicare for Prashant Kumar's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Prashant Kumar reassigns Medicare benefits to E T Nephrology Associates PA (Lufkin, TX). The 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 Prashant Kumar's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Prashant Kumar accept?

Health plans from Blue Cross and Blue Shield of Texas and UnitedHealthcare list Prashant 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 Prashant Kumar affiliated with any hospitals?

According to CMS data, Prashant Kumar is affiliated with Chi St Lukes Health Memorial Lufkin, Chi St Lukes Health Memorial Livingston, Tyler County Hospital, Woodland Heights Medical Center and Sabine County Hospital.

When was this NPI record last updated?

The NPPES record for Prashant Kumar was last updated on March 17, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.