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DR. RAHUL KUMAR MD, MBBS
NPI 1497910186
Internal Medicine in San Tan Valley, AZ

Active since July 23, 2008PECOS EnrolledAccepts Medicare Assignment
92.29/100
CMS Quality Rating
37000 N GANTZEL RD, SAN TAN VALLEY, AZ 85140(952) 892-2000 Get Directions Write a Review

NPPES record last updated: October 4, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 4, 2022, Mar 23, 2019, Jan 19, 2018 (3 updates tracked since 2018).

About Dr. Rahul Kumar Md, Mbbs NPPES

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

DR. RAHUL KUMAR MD, MBBS (NPI 1497910186) is an individual internal medicine provider in San Tan Valley, Arizona, licensed in Arizona (66113) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS and is a graduate of Other (2003).

NPPES Registry Identity

NPI1497910186
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. RAHUL KUMARCredential: MD, MBBS
Location Address37000 N GANTZEL RDSan Tan Valley, AZ 85140-7303
Mailing Address37000 N Gantzel RdSan Tan Valley, AZ 85140-7303
Phone(952) 892-2000
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateJuly 23, 2008
Last NPPES UpdateOctober 4, 20223 updates tracked since enumeration
NPPES CertifiedOctober 4, 2022
✔ NPI 1497910186 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in AZ · 66113✔ Licensed in NM · MD20110485✔ Licensed in PA · MT193304✔ Licensed in MN · 62991
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
37000 N GANTZEL RD, San Tan Valley, AZ 85140
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Accepted Insurance

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

Dr. Rahul Kumar Md, Mbbs 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 ID3870768385
PECOS Enrollment IDI20220817003461
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 5

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.
256 services127 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
134 services128 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.
89 services45 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.
67 services66 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.
15 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85140 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
$127.71 typical visit price
range $55.44 – $168.60
Typical copayment $31.92 (range $13.86 – $42.15)
Most-billed visit code 99204
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
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.

92.29/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability98
Improvement Activities40
Cost66.94

Referred Medical Equipment & Supplies CMS DME claims 2

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

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers40 claims40 services$64.46 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier25 claims25 services$32.23 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 20

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

NICHOLAS NIEMYER RN
Nurse Practitioner (Neonatal, Critical Care)
37000 N GANTZEL RD
QUEEN CREEK, AZ 85140
Maricopa County (602) 476-8962
YANG XUAN DO
Hospitalist
37000 N GANTZEL RD
SAN TAN VALLEY, AZ 85140
Maricopa County (480) 943-7124
DANIELLA ROCHELLE CLEVELAND FNP
Nurse Practitioner (Family)
37000 N GANTZEL RD
QUEEN CREEK, AZ 85140
Maricopa County (480) 394-4000
ANDREW MICHAEL SMITH M.D
Emergency Medicine
37000 N GANTZEL RD
SAN TAN VALLEY, AZ 85140
Maricopa County (480) 394-4000
BRIANNA JENNAS AGANP
Nurse Practitioner
37000 N GANTZEL RD
QUEEN CREEK, AZ 85140
Maricopa County (480) 394-4000
JOHN CRUZ ORTIZ JR. ACNP
Nurse Practitioner (Acute Care)
37000 N GANTZEL RD
SAN TAN VALLEY, AZ 85140
Maricopa County (480) 394-4000
BANNER IRONWOOD MEDICAL CENTER
General Acute Care Hospital
37000 N GANTZEL RD
QUEEN CREEK, AZ 85140
Maricopa County (480) 394-4000
BANNER HOSPITAL BASED PHYSICIANS ARIZONA LLC
Clinic/Center (Multi-Specialty)
37000 N GANTZEL RD
SAN TAN VALLEY, AZ 85140
Maricopa County (480) 543-2034

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 Rahul Kumar's NPI number?

The NPI number for Rahul Kumar is 1497910186. It was assigned to this individual provider in the NPPES registry on July 23, 2008.

Where is Rahul Kumar located?

Rahul Kumar practices at 37000 N Gantzel Rd, San Tan Valley, AZ 85140. The listed phone number is (952) 892-2000.

What is Rahul Kumar's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Rahul Kumar enrolled in Medicare?

Yes. Rahul 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 Rahul Kumar accept?

Health plans from Oscar Health Plan, Inc. list Rahul 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 Rahul Kumar was last updated on October 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.