NILAY KUMAR M.D., M.P.H
NPI 1427123702
Internal Medicine - Gastroenterology in Milwaukee, WI

Q: What is Nilay Kumar's NPI number?

The NPI number for Nilay Kumar is 1427123702. It was assigned to this individual provider in the NPPES registry on November 21, 2006.

Q: What is Nilay Kumar's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Nilay Kumar was last updated on May 23, 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.

Active since November 21, 2006PECOS EnrolledAccepts Medicare Assignment

2901 W KK RIVER PKWY, SUITE 414, MILWAUKEE, WI 53215(414) 649-3750 Get Directions Write a Review

NPPES record last updated: May 23, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Nilay Kumar M.d., M.p.h NPPES

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

NILAY KUMAR M.D., M.P.H (NPI 1427123702) is an individual gastroenterology provider in Milwaukee, Wisconsin, licensed in Wisconsin (49637) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS, is affiliated with Aurora Health Care Central Inc, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1427123702

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameNILAY KUMARCredential: M.D., M.P.H

Location Address2901 W KK RIVER PKWY, SUITE 414Milwaukee, WI 53215-3677

Mailing AddressPo Box 735044Chicago, IL 60673 · (800) 326-2250

Phone(414) 649-3750

Sole ProprietorNo

Medical School CMSOtherGraduated 2004

Enumeration DateNovember 21, 2006

Last NPPES UpdateMay 23, 2024

NPPES CertifiedMay 23, 2024

✔ NPI 1427123702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in WI · 49637

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 49637 (WI)

2901 W KK RIVER PKWY, Milwaukee, WI 53215

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Other Identifiers 2

Medicaid35128200WI

Other77501WI · Medical College Of Wiscon

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.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

Nilay Kumar M.d., M.p.h 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 ID4789757071

PECOS Enrollment IDI20080719000112

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 14

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.

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.

373 services164 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.

169 services121 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.

167 services152 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.

116 services116 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

89 services89 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

76 services68 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.

41 services40 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

38 services38 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.

20 services20 patients

Balloon dilation of esophagus, stomach, and/or upper small bowel using a flexible endoscope, less than 3.0 cm 43249

This procedure involves using a flexible tube with a camera, called an endoscope, to gently expand narrowed areas in your esophagus, stomach, or upper small bowel. A small balloon is inflated, making it easier for food and liquid to pass through. It's safe and effective.

19 services15 patients

Control of bleeding of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43255

This procedure involves using a flexible tube with a light, called an endoscope, to examine and treat bleeding in the esophagus, stomach, or upper small bowel. It's a safe, effective way to control bleeding and ensure your digestive health.

18 services17 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

13 services13 patients

Injection beneath lining of large bowel using a flexible endoscope 45381

This procedure involves a flexible tube, called an endoscope, being inserted into the large bowel. A small needle is then passed through the tube to inject medication under the bowel lining. This is typically done to treat inflammation or bleeding.

12 services12 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.

12 services12 patients

Hospital Affiliations CMS Care Compare 4

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

Aurora Health Care Central Inc

Acute Care Hospitals · Sheboygan, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520035

Location3400 Union AveSheboygan, WI 53081 · Sheboygan County

Emergency services Birthing friendly

Aurora St Lukes Medical Center

Acute Care Hospitals · Milwaukee, WI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520138

Location2900 W Oklahoma AveMilwaukee, WI 53215 · Milwaukee County

Emergency services Birthing friendly

West Allis Memorial Hospital

Acute Care Hospitals · West Allis, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520139

Location8901 W Lincoln AveWest Allis, WI 53227 · Milwaukee County

Emergency services Birthing friendly

Aurora Medical Center

Acute Care Hospitals · Grafton, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520207

Location975 Port Washington RoadGrafton, WI 53024 · Ozaukee County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53215 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

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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.

Other Providers at the Same Location NPPES 8

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

TARUN SHARMA MD

Internal Medicine (Gastroenterology)

2901 W KK RIVER PKWY, SUITE 414
MILWAUKEE, WI 53215

Milwaukee County (414) 649-3750

MRS. RUTH ANN TREISMAN ARNP

Nurse Practitioner (Adult Health)

2901 W KK RIVER PKWY, SUITE 415
MILWAUKEE, WI 53215

Milwaukee County (414) 385-3082

MRS. ERIN C LASSANSKE NP

Nurse Practitioner (Family)

2901 W KK RIVER PKWY, STE 305
MILWAUKEE, WI 53215

Milwaukee County (414) 645-6070

TARUN KAURA

Internal Medicine (Gastroenterology)

2901 W KK RIVER PKWY, SUITE 414
MILWAUKEE, WI 53215

Milwaukee County (414) 649-3750

FRANKLIN D. LOO M.D.

Internal Medicine (Gastroenterology)

2901 W KK RIVER PKWY, SUITE 414
MILWAUKEE, WI 53215

Milwaukee County (414) 649-3750

ABE F. GOLDBAUM M.D., S.C.

Neuromusculoskeletal Medicine, Sports Medicine

2901 W KK RIVER PKWY, STE 106,
MILWAUKEE, WI 53215

Milwaukee County (414) 649-7710

HOWARD J ZEFT MD

Internal Medicine (Cardiovascular Disease)

2901 W KK RIVER PKWY, STE 840
MILWAUKEE, WI 53215

Milwaukee County (414) 649-3530

DR. IMRAN K NIAZI MD

Internal Medicine (Clinical Cardiac Electrophysiology)

2901 W KK RIVER PKWY, STE 305
MILWAUKEE, WI 53215

Milwaukee County (414) 645-6070

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 Nilay Kumar's NPI number?

The NPI number for Nilay Kumar is 1427123702. It was assigned to this individual provider in the NPPES registry on November 21, 2006.

Where is Nilay Kumar located?

Nilay Kumar practices at 2901 W Kk River Pkwy Suite 414, Milwaukee, WI 53215. The listed phone number is (414) 649-3750.

What is Nilay Kumar's specialty?

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

Is Nilay Kumar enrolled in Medicare?

Yes. Nilay 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 Nilay Kumar accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and Quartz and 1 other insurer list Nilay 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 Nilay Kumar affiliated with any hospitals?

According to CMS data, Nilay Kumar is affiliated with Aurora Health Care Central Inc, Aurora St Lukes Medical Center, West Allis Memorial Hospital and Aurora Medical Center.

When was this NPI record last updated?

The NPPES record for Nilay Kumar was last updated on May 23, 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.