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DR. KANIK PRADEEP KATHURIA M.D.
NPI 1609118140
Internal Medicine in Newark, NJ

Active since March 22, 2013PECOS EnrolledAccepts Medicare Assignment
80.87/100
CMS Quality Rating
201 LYONS AVE, NEWARK, NJ 07112(973) 926-7425(973) 926-6130 Get Directions Write a Review

NPPES record last updated: December 6, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 6, 2019, Jul 11, 2017 (2 updates tracked since 2017).

About Dr. Kanik Pradeep Kathuria M.d. NPPES

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

DR. KANIK PRADEEP KATHURIA M.D. (NPI 1609118140) is an individual internal medicine provider in Newark, New Jersey, licensed in Indiana (01078171A) and active in the NPI registry since March 2013. He is enrolled in Medicare PECOS, is affiliated with Northwest Health - Porter, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1609118140
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. KANIK PRADEEP KATHURIACredential: M.D.
Location Address201 LYONS AVENewark, NJ 07112-2027
Mailing Address201 Lyons AveNewark, NJ 07112-2027
Phone(973) 926-7425
Fax(973) 926-6130
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateMarch 22, 2013
Last NPPES UpdateDecember 6, 20192 updates tracked since enumeration
✔ NPI 1609118140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IN · 01078171A
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.
Also ListedHospitalistTaxonomy 208M00000X · License 4301111188 (MI)
201 LYONS AVE, Newark, NJ 07112
Open in Google Maps ↗

Accepted Insurance

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

Dr. Kanik Pradeep Kathuria 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 ID1951698174
PECOS Enrollment IDI20170315000709
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 Reassignments

5

Medicare enrollment records show Kanik Kathuria reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Hospitalist Physicians Of Indiana, PC
578 mi
Hospitalist
7950 W JEFFERSON BLVD
Fort Wayne, IN 46804
  • Reassigned Medicare billing, Indiana enrollment
  • 309 clinicians in this Medicare group
NPI 1306576277 (260) 435-7001
Apogee Medical Group Indiana PC
608 mi
Internal Medicine
200 HIGH PARK AVE
Goshen, IN 46526
  • Reassigned Medicare billing, Indiana enrollment
  • 172 clinicians in this Medicare group
NPI 1093973885 (574) 364-2510
Northwest Hospitalist Physicians LLP
655 mi
Hospitalist
1007 LINCOLNWAY
La Porte, IN 46350
  • Reassigned Medicare billing, Indiana enrollment
  • 75 clinicians in this Medicare group
NPI 1326415423 (219) 326-1234
Inpatient Consultants Of Illinois, P.C.
717 mi
Hospitalist
15 SALT CREEK LN, SUITE 111
Hinsdale, IL 60521
  • Reassigned Medicare billing, Illinois enrollment
  • 108 clinicians in this Medicare group
NPI 1548442569 (630) 371-0133
Apogee Medical Group Georgia Inc
775 mi
Internal Medicine
705 DIXIE ST
Carrollton, GA 30117
  • Reassigned Medicare billing, Georgia enrollment
  • 335 clinicians in this Medicare group
NPI 1629025143 (770) 836-9667

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 4

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.
486 services205 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.
166 services161 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.
116 services70 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.
52 services52 patients

Hospital Affiliations CMS Care Compare

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

Northwest Health - Porter

Acute Care Hospitals · Valparaiso, IN
3/5 CMS rating
OwnershipProprietary
CMS Certification Number150035
Location85 East Us Hwy 6Valparaiso, IN 46383 · Porter County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07112 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
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
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.

80.87/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality76.47
Improvement Activities40
Cost57.57

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.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier28 claims28 services$14.35 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 supplier28 claims28 services$61.76 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.

DR. KEITH MICHAEL SPELLMAN M.D.
Radiology (Diagnostic Radiology)
201 LYONS AVE
NEWARK, NJ 07112
Essex County (973) 926-7960
DR. LARISSA SOPHIA DUDLEY M.D.
Emergency Medicine
201 LYONS AVE, SUITE D11
NEWARK, NJ 07112
Essex County (973) 926-6671
WAQAS BARI MD
Student in an Organized Health Care Education/Training Program
201 LYONS AVE
NEWARK, NJ 07112
Essex County (800) 843-2384
ERIKA YESENIA PINEDA MD
Pediatrics (Pediatric Critical Care Medicine)
201 LYONS AVE
NEWARK, NJ 07112
Essex County (973) 926-7000
CASEY YEONJOO CHO APN
Nurse Practitioner (Acute Care)
201 LYONS AVE
NEWARK, NJ 07112
Essex County (973) 926-6938
KARLINA NGUYEN PA-C
Physician Assistant
201 LYONS AVE
NEWARK, NJ 07112
Essex County (973) 926-7000
BRIAN CAO MD
Anesthesiology (Pediatric Anesthesiology)
201 LYONS AVE
NEWARK, NJ 07112
Essex County (973) 926-7000
DR. ALEXIS LORDI MD
Student in an Organized Health Care Education/Training Program
201 LYONS AVE
NEWARK, NJ 07112
Essex County (973) 900-4855

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 Kanik Kathuria's NPI number?

The NPI number for Kanik Kathuria is 1609118140. It was assigned to this individual provider in the NPPES registry on March 22, 2013.

Where is Kanik Kathuria located?

Kanik Kathuria practices at 201 Lyons Ave, Newark, NJ 07112. The listed phone number is (973) 926-7425.

What is Kanik Kathuria's specialty?

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

Is Kanik Kathuria enrolled in Medicare?

Yes. Kanik Kathuria 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.

Which organizations bill Medicare for Kanik Kathuria's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kanik Kathuria reassigns Medicare benefits to 5 organizations: Hospitalist Physicians Of Indiana, PC (Fort Wayne, IN), Apogee Medical Group Indiana PC (Goshen, IN), Northwest Hospitalist Physicians LLP (La Porte, IN), Inpatient Consultants Of Illinois, P.C. (Hinsdale, IL) and Apogee Medical Group Georgia Inc (Carrollton, GA). Each 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 Kanik Kathuria's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kanik Kathuria accept?

Health plans from CareSource, Oscar Health and Oscar Insurance Company list Kanik Kathuria 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 Kanik Kathuria affiliated with any hospitals?

According to CMS data, Kanik Kathuria is affiliated with Northwest Health - Porter.

When was this NPI record last updated?

The NPPES record for Kanik Kathuria was last updated on December 6, 2019. 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.