AWANI KUMAR MD
NPI 1497720635
Internal Medicine - Pulmonary Disease in Toms River, NJ

Q: What is Awani Kumar's NPI number?

The NPI number for Awani Kumar is 1497720635. It was assigned to this individual provider in the NPPES registry on February 21, 2006.

Q: What is Awani Kumar's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Awani Kumar was last updated on April 28, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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 February 21, 2006PECOS EnrolledAccepts Medicare Assignment

15.89/100

CMS Quality Rating

780 HWY 37 W, SUITE 110, TOMS RIVER, NJ 08755(732) 341-3500 Get Directions Write a Review

NPPES record last updated: April 28, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Awani Kumar Md NPPES

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

AWANI KUMAR MD (NPI 1497720635) is an individual pulmonary disease provider in Toms River, New Jersey, licensed in New Jersey (MA 66307) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Community Medical Center, and is a graduate of Other (1987).

NPPES Registry Identity

NPI1497720635

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameAWANI KUMARCredential: MD

Location Address780 HWY 37 W, SUITE 110Toms River, NJ 08755-5014

Mailing Address780 Hwy 37 W, Suite 110Toms River, NJ 08755-5014 · (732) 341-3500

Phone(732) 341-3500

Sole ProprietorYes

Medical School CMSOtherGraduated 1987

Enumeration DateFebruary 21, 2006

Last NPPES UpdateApril 28, 2008

✔ NPI 1497720635 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in NJ · MA 66307

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

780 HWY 37 W, Toms River, NJ 08755

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Other Identifiers 3

Medicare UPINF 60572NJ

Medicare PIN009649UB9

Medicaid7568703NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.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

Awani 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 ID3072559533

PECOS Enrollment IDI20050706000739

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 Awani Kumar reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Awani Kumar, MD, PC

Same address

Pulmonary Disease

780 HWY 37 W, SUITE 110
Toms River, NJ 08755

Reassigned Medicare billing, New Jersey enrollment
3 clinicians in this Medicare group

NPI 1811175755 (732) 341-3500

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 20

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 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.

2,408 services349 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.

2,144 services336 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.

1,014 services381 patients

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.

323 services206 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.

276 services248 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

234 services232 patients

Test to measure largest amount of air breathed in an out 94200

This test, called spirometry, measures your lung capacity. It involves taking a deep breath and then exhaling as forcefully as possible into a machine. The results help assess how well your lungs function.

234 services232 patients

Test to determine lung volumes using gas dilution or washout 94727

This test measures lung volumes by either diluting or washing out a known amount of gas in your lungs. You'll breathe in a harmless gas, then exhale. The exhaled air is analyzed to assess your lung capacity and function.

234 services232 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

234 services232 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.

163 services73 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

80 services25 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.

53 services48 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.

47 services47 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.

46 services40 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

38 services37 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.

29 services29 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

20 services20 patients

Test to determine lung volumes using gas dilution or washout 94727

20 services20 patients

Test to examine how well the lungs exchange gases 94729

20 services20 patients

Test to measure largest amount of air breathed in an out 94200

19 services19 patients

Hospital Affiliations CMS Care Compare 5

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

Community Medical Center

Acute Care Hospitals · Toms River, NJ

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310041

Location99 Rt 37 WestToms River, NJ 08755 · Ocean County

Emergency services Birthing friendly

Ocean Medical Center

Acute Care Hospitals · Brick, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number310052

Location425 Jack Martin BlvdBrick, NJ 08724 · Ocean County

Emergency services Birthing friendly

Jersey Shore University Medical Center

Acute Care Hospitals · Neptune, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310073

Location1945 State Route 33Neptune, NJ 07753 · Monmouth County

Emergency services Birthing friendly

Monmouth Medical Center-Southern Campus

Acute Care Hospitals · Lakewood, NJ

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310084

Location600 River AveLakewood, NJ 08701 · Ocean County

Emergency services

Jfk Medical Center

Acute Care Hospitals · Edison, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310108

Location65 James StreetEdison, NJ 08820 · Middlesex County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08755 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

$140.34 typical visit price

range $61.59 – $185.05

Typical copayment $35.08 (range $15.39 – $46.26)

Most-billed visit code 99204

Established Patient

$107.94 typical visit price

range $20.08 – $150.98

Typical copayment $26.98 (range $5.02 – $37.74)

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.

15.89/100

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

Individually scored

Quality

Improvement Activities

Cost

52.99

Reported Quality Measures

Diabetes: Medical Attention for Nephropathy

The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period

68%116 patients3/55-star benchmark: 99%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

75%3,211 patients2/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

99%2,696 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period

39%679 patients2/55-star benchmark: 99%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

84%3,511 patients3/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

34%1,009 patients2/55-star benchmark: 99%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user

Patients screenedForUse: 38% · 799 patients

Patients tobacco: 35% · 799 patients

48%31 patients2/55-star benchmark: 98%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

57%1,009 patients3/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

0%1,009 patients1/55-star benchmark: 59%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 23

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

Tubing with integrated heating element for use with positive airway pressure device A4604