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NISHANTH GIRIJA KUMAR M.D.
NPI 1548643752
Internal Medicine - Nephrology in Worcester, MA

Active since July 07, 2015PECOS Enrolled
123 SUMMER ST, WORCESTER, MA 01608(508) 363-6208 Get Directions Write a Review

NPPES record last updated: May 11, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 11, 2020, Jun 18, 2017 (2 updates tracked since 2017).

About Nishanth Girija Kumar M.d. NPPES

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

NISHANTH GIRIJA KUMAR M.D. (NPI 1548643752) is an individual nephrology provider in Worcester, Massachusetts, licensed in Kentucky (53686) and active in the NPI registry since July 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1548643752
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameNISHANTH GIRIJA KUMARCredential: M.D.
Location Address123 SUMMER STWorcester, MA 01608-1216
Mailing Address105 Financial Pl, Ste 105Elizabethtown, KY 42701-8437 · (270) 765-5112 · Fax (270) 737-9252
Phone(508) 363-6208
Sole ProprietorYes
Enumeration DateJuly 7, 2015
Last NPPES UpdateMay 11, 20202 updates tracked since enumeration
NPPES CertifiedMay 11, 2020
✔ NPI 1548643752 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in KY · 53686
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
123 SUMMER ST, Worcester, MA 01608
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nishanth Girija Kumar M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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

Middletown Medical PC
145 mi
Emergency Medicine
111 MALTESE DR
Middletown, NY 10940
  • Reassigned Medicare billing, New York enrollment
  • 281 clinicians in this Medicare group
NPI 1902855828 (845) 342-4774

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01608 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
$134.47 typical visit price
range $58.86 – $177.36
Typical copayment $33.61 (range $14.71 – $44.34)
Most-billed visit code 99204
Established Patient
$103.48 typical visit price
range $19.11 – $144.84
Typical copayment $25.87 (range $4.77 – $36.21)
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.

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.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier11 claims11 services$21.28 avg. paid by Medicare
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
1 supplier11 claims11 services$119.27 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
1 supplier12 claims12 services$11.65 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.

MADAIAH LOKESHWARI M.D.
Hospitalist
123 SUMMER ST
WORCESTER, MA 01608
Worcester County (508) 363-6849
DR. MADHAV SHARMA MD
Internal Medicine
123 SUMMER ST
WORCESTER, MA 01608
Worcester County (508) 363-5438
YESHASWINI KATKOORI MD
Student in an Organized Health Care Education/Training Program
123 SUMMER ST
WORCESTER, MA 01608
Worcester County (508) 363-5000
DANIELLE MAY PELOQUIN
Nurse Anesthetist, Certified Registered
123 SUMMER ST
WORCESTER, MA 01608
Worcester County (508) 363-5000
DR. YAYAN CHEN M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
123 SUMMER ST
WORCESTER, MA 01608
Worcester County (508) 363-6049
FARRICY & KRAFT LLP
Obstetrics & Gynecology (Obstetrics)
123 SUMMER ST, SUITE 560
WORCESTER, MA 01608
Worcester County (508) 363-6100
KEITH A BEALS PA
Physician Assistant
123 SUMMER ST
WORCESTER, MA 01608
Worcester County (508) 363-5000
ANNE E COVINO CNM
Midwife
123 SUMMER ST
WORCESTER, MA 01608
Worcester County (508) 363-5000

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 Nishanth Girija Kumar's NPI number?

The NPI number for Nishanth Girija Kumar is 1548643752. It was assigned to this individual provider in the NPPES registry on July 7, 2015.

Where is Nishanth Girija Kumar located?

Nishanth Girija Kumar practices at 123 Summer St, Worcester, MA 01608. The listed phone number is (508) 363-6208.

What is Nishanth Girija Kumar's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Nishanth Girija Kumar enrolled in Medicare?

Yes. Nishanth Girija Kumar is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Nishanth Girija Kumar's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nishanth Girija Kumar reassigns Medicare benefits to Middletown Medical PC (Middletown, NY). 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 Nishanth Girija Kumar's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nishanth Girija Kumar was last updated on May 11, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.