DR. SUMIT KUMAR M.D.
NPI 1598743098
Internal Medicine - Nephrology in Dallas, TX

Q: What is Sumit Kumar's NPI number?

The NPI number for Sumit Kumar is 1598743098. It was assigned to this individual provider in the NPPES registry on January 4, 2006.

Q: What is Sumit Kumar's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Sumit Kumar was last updated on July 18, 2023. 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.

Active since January 04, 2006PECOS EnrolledAccepts Medicare Assignment

9900 N CENTRAL EXPY STE 215, DALLAS, TX 75231(214) 396-4950(877) 423-5360 Get Directions Write a Review

NPPES record last updated: July 18, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 18, 2023, May 23, 2023 (2 updates tracked since 2023).

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About Dr. Sumit Kumar M.d. NPPES

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

DR. SUMIT KUMAR M.D. (NPI 1598743098) is an individual nephrology provider in Dallas, Texas, licensed in Texas (L2973) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with Texas Health Presbyterian Hospital Dallas, and is a graduate of Other (1991).

NPPES Registry Identity

NPI1598743098

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameDR. SUMIT KUMARCredential: M.D.

Location Address9900 N CENTRAL EXPY STE 215Dallas, TX 75231-0929

Mailing Address9900 N Central Expy Ste 215Dallas, TX 75231-0929 · (214) 396-4950 · Fax (877) 423-5360

Phone(214) 396-4950

Fax(877) 423-5360

Sole ProprietorYes

Medical School CMSOtherGraduated 1991

Enumeration DateJanuary 4, 2006

Last NPPES UpdateJuly 18, 20232 updates tracked since enumeration

NPPES CertifiedJuly 18, 2023

✔ NPI 1598743098 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 TX · L2973

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.

9900 N CENTRAL EXPY STE 215, Dallas, TX 75231

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Other Identifiers 1

Medicaid149501201TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections 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

Dr. Sumit Kumar 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 ID3678679776

PECOS Enrollment IDI20091006000705

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.

Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days 99454

This service involves using devices to remotely track body functions like heart rate or blood pressure. These devices, provided initially, record data daily or send alerts if readings are abnormal. The service is renewed every 30 days.

623 services100 patients

Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457

This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.

566 services115 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

420 services108 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.

324 services190 patients

Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes 99458

This service involves analyzing your vital signs, like heart rate and blood pressure, remotely collected over a month. Each additional 20 minutes spent on management refers to extra time spent reviewing, interpreting your data, and planning your care. It's a critical part of ensuring your wellbeing.

299 services82 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

255 services88 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.

233 services157 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.

194 services93 patients

Dialysis services, 4 or more physician visits per month (20 years or older) 90960

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.

103 services22 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.

86 services53 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.

63 services63 patients

Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment 99453

Remote monitoring of physiologic parameters involves using special equipment to track vital signs like heart rate and blood pressure from a distance. The initial set-up includes installing the device and teaching the patient how to use it correctly for accurate readings.

57 services57 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.

39 services38 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

33 services33 patients

Insertion of needle and/or tube into hemodialysis circuit and balloon dilation of dialysis segment with review by radiologist 36902

This procedure involves inserting a needle or tube into your hemodialysis circuit, a system that cleans your blood when your kidneys can't. A balloon is then used to widen a narrow section of this circuit. A radiologist reviews the procedure to ensure accuracy.

27 services19 patients

Hospital Affiliations CMS Care Compare 3

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

Texas Health Presbyterian Hospital Dallas

Acute Care Hospitals · Dallas, TX

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number450462

Location8200 Walnut Hill LaneDallas, TX 75231 · Dallas County

Emergency services Birthing friendly

Medical City Dallas Hospital

Acute Care Hospitals · Dallas, TX

3/5 CMS rating

OwnershipProprietary

CMS Certification Number450647

Location7777 Forest LaneDallas, TX 75230 · Dallas County

Emergency services Birthing friendly

Medical City Plano

Acute Care Hospitals · Plano, TX

3/5 CMS rating

OwnershipProprietary

CMS Certification Number450651

Location3901 W 15th StPlano, TX 75075 · Collin County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75231 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

$131.01 typical visit price

range $57.18 – $172.86

Typical copayment $32.75 (range $14.29 – $43.21)

Most-billed visit code 99204

Established Patient

$100.80 typical visit price

range $18.48 – $141.20

Typical copayment $25.20 (range $4.62 – $35.30)

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.

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

100%434 patients5/55-star benchmark: 100%

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

100%266 patients5/55-star benchmark: 100%

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.

100%1,638 patients5/55-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.

86%638 patients4/55-star benchmark: 100%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

19%42 patients1/55-star benchmark: 98%

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.

100%21 patients5/55-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.

66%316 patients3/55-star benchmark: 100%

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

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

99%719 patients4/55-star benchmark: 100%

Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user

100%470 patients5/55-star benchmark: 100%

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…

85%316 patients4/55-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…

77%316 patients4/55-star benchmark: 79%

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.

Other Providers at the Same Location NPPES 9

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

UMA B.R.K PAKKIVENKATA M.D.

Internal Medicine (Nephrology)