KARL WILLIAM KUMLER III M.D.
NPI 1558344374
Orthopaedic Surgery in Cambridge, OH

Q: What is Karl Kumler's NPI number?

The NPI number for Karl Kumler is 1558344374. It was assigned to this individual provider in the NPPES registry on November 25, 2005.

Q: What is Karl Kumler's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Karl Kumler was last updated on January 8, 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 25, 2005PECOS EnrolledAccepts Medicare Assignment

58.11/100

CMS Quality Rating

1230A CLARK ST, CAMBRIDGE, OH 43725(740) 435-2340 Get Directions Write a Review

NPPES record last updated: January 8, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Karl William Kumler Iii M.d. NPPES

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

KARL WILLIAM KUMLER III M.D. (NPI 1558344374) is an individual orthopaedic surgery provider in Cambridge, Ohio, licensed in Ohio (0980417) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Genesis Hospital, and is a graduate of University Of Cincinnati College Of Medicine (1995).

NPPES Registry Identity

NPI1558344374

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameKARL WILLIAM KUMLER IIICredential: M.D.

Location Address1230A CLARK STCambridge, OH 43725-9807

Mailing AddressPo Box 7527Dublin, OH 43017-0727

Phone(740) 435-2340

Sole ProprietorNo

Medical School CMSUniversity Of Cincinnati College Of MedicineGraduated 1995

Enumeration DateNovember 25, 2005

Last NPPES UpdateJanuary 8, 2024

NPPES CertifiedJanuary 8, 2024

✔ NPI 1558344374 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in OH · 0980417

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

1230A CLARK ST, Cambridge, OH 43725

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Other Identifiers 2

Other0901393OH · Dmerc

Medicaid2179002OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, MedMutual, Molina Healthcare.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

Karl William Kumler Iii 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 ID9638061195

PECOS Enrollment IDI20040419000872

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 15

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

490 services108 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

194 services101 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

133 services102 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.

128 services106 patients

X-ray of knee, 1-2 views 73560

An X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.

125 services95 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.

88 services79 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

59 services37 patients

X-ray of both knees while standing 73565

An X-ray of both knees while standing is a diagnostic procedure that captures images of your knee joints. You'll stand in front of an X-ray machine, and it will take pictures showing the bones and tissues in your knees. This helps doctors identify any abnormalities or injuries.

58 services55 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.

57 services57 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

55 services55 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

34 services34 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

32 services30 patients

Injection into tendon or ligament 20550

An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.

27 services12 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

21 services21 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.

20 services20 patients

Hospital Affiliations CMS Care Compare 3

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

Genesis Hospital

Acute Care Hospitals · Zanesville, OH

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360039

Location2951 Maple AvenueZanesville, OH 43701 · Muskingum County

Emergency services Birthing friendly

Southeastern Ohio Regional Medical Center

Acute Care Hospitals · Cambridge, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360203

Location1341 North Clark StreetCambridge, OH 43725 · Guernsey County

Emergency services Birthing friendly

Barnesville Hospital Association, Inc

Critical Access Hospitals · Barnesville, OH

OwnershipVoluntary non-profit - Private

CMS Certification Number361321

Location639 West Main StreetBarnesville, OH 43713 · Belmont County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43725 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

$84.72 typical visit price

range $54.34 – $166.65

Typical copayment $21.18 (range $13.58 – $41.66)

Most-billed visit code 99203

Established Patient

$68.07 typical visit price

range $17.10 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

Most-billed visit code 99213

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.

58.11/100

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

Individually scored

Quality

64.65

Promoting Interoperability

Improvement Activities

Cost

20.73

Reported Quality Measures

Adult Major Depressive Disorder (MDD): Suicide Risk Assessment

20%30 patients

Closing the Referral Loop: Receipt of Specialist Report

28%43 patients2/55-star benchmark: 87%

Colorectal Cancer Screening

13%846 patients1/55-star benchmark: 88%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

73%86 patients2/55-star benchmark: 91%

e-Prescribing

83%86 patients1/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

15%1,339 patients1/55-star benchmark: 98%

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

Patients combinedPopulations: 14% · 944 patients

Patients screened: 13% · 944 patients

58%67 patients3/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

65%711 patients3/55-star benchmark: 100%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 575 patients

Patients totalRate: 0% · 575 patients

0%575 patients5/55-star benchmark: 100%

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 4

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

Synthetic sheepskin pad E0188

DME-Other DME · category DE000N

1 supplier21 claims21 services$23.66 avg. paid by Medicare

Continuous passive motion exercise device for use on knee only E0935

DME-Other DME · category DE000N

1 supplier27 claims483 services$21.50 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

1 supplier12 claims12 services$22.55 avg. paid by Medicare

Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf L3908

DME-Orthotic Devices · category DF000N

1 supplier11 claims11 services$55.45 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

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

SARA ASHLEY SAFT PA-C

Physician Assistant

1230A CLARK ST
CAMBRIDGE, OH 43725

Guernsey County (740) 435-2340

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 Karl Kumler's NPI number?

The NPI number for Karl Kumler is 1558344374. It was assigned to this individual provider in the NPPES registry on November 25, 2005.

Where is Karl Kumler located?

Karl Kumler practices at 1230A Clark St, Cambridge, OH 43725. The listed phone number is (740) 435-2340.

What is Karl Kumler's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Karl Kumler enrolled in Medicare?

Yes. Karl Kumler 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 Karl Kumler accept?

Health plans from CareSource, MedMutual and Molina Healthcare list Karl Kumler 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 Karl Kumler affiliated with any hospitals?

According to CMS data, Karl Kumler is affiliated with Genesis Hospital, Southeastern Ohio Regional Medical Center and Barnesville Hospital Association, Inc.

When was this NPI record last updated?

The NPPES record for Karl Kumler was last updated on January 8, 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.