DR. SMITHA KUMAR MD
NPI 1619965688
Family Medicine in Gilroy, CA

Active since October 12, 2005PECOS EnrolledAccepts Medicare Assignment
97/100
CMS Quality Rating
9460 NO NAME UNO, 115, GILROY, CA 95020(408) 842-3133(408) 842-2229 Get Directions Write a Review

NPPES record last updated: March 4, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Smitha Kumar Md NPPES

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

DR. SMITHA KUMAR MD (NPI 1619965688) is an individual family medicine provider in Gilroy, California, licensed in California (A88107) and active in the NPI registry since October 2005. She is enrolled in Medicare PECOS and is a graduate of Other (1994).

NPPES Registry Identity

NPI1619965688
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. SMITHA KUMARCredential: MD
Location Address9460 NO NAME UNO, 115Gilroy, CA 95020-3537
Mailing Address9460 No Name Uno, 115Gilroy, CA 95020-3537 · (408) 842-3133 · Fax (408) 842-2229
Fax(408) 842-2229
Sole ProprietorNo
Medical School CMSOtherGraduated 1994
Enumeration DateOctober 12, 2005
Last NPPES UpdateMarch 4, 2025
NPPES CertifiedMarch 4, 2025
NPI 1619965688 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in CA · A88107
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
9460 NO NAME UNO, Gilroy, CA 95020

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. Smitha Kumar Md 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 ID6709804396
PECOS Enrollment IDI20051102000544
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 16

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.

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.
640 services336 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.
606 services342 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
341 services341 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
330 services330 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.
267 services267 patients
Telephone medical discussion with physician, 11-20 minutes 99442
This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.
53 services48 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95020 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
$106.47 typical visit price
range $70.37 – $206.04
Typical copayment $26.61 (range $17.59 – $51.51)
Most-billed visit code 99203
Established Patient
$121.77 typical visit price
range $23.96 – $169.60
Typical copayment $30.44 (range $5.99 – $42.40)
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.

97/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality94.01
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Appropriate Testing for Pharyngitis
3%31 patients1/55-star benchmark: 100%
Appropriate Treatment for Upper Respiratory Infection (URI)
77%35 patients4/55-star benchmark: 100%
Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture
Lower rates are better for this measure.
0%113 patients
Breast Cancer Screening
89%487 patients4/55-star benchmark: 93%
Cervical Cancer Screening
40%493 patients2/55-star benchmark: 98%
Chlamydia Screening for Women
17%30 patients
Colorectal Cancer Screening
85%916 patients4/55-star benchmark: 88%
Controlling High Blood Pressure
72%561 patients4/55-star benchmark: 91%
Diabetes: Eye Exam
9%190 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
17%190 patients4/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
99%3,941 patients4/55-star benchmark: 100%
e-Prescribing
100%3,079 patients5/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
96%689 patients4/55-star benchmark: 100%
HIV Screening
10%969 patients1/55-star benchmark: 60%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
59%1,583 patients3/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
93%1,318 patients4/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 96% · 1,305 patients
Patients screened: 97% · 1,305 patients
73%40 patients3/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
99%776 patients4/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
84%460 patients4/55-star benchmark: 91%
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 11

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
17 suppliers62 claims153 services$5.92 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
8 suppliers21 claims22 services$1.01 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
6 suppliers17 claims17 services$34.55 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
5 suppliers18 claims107 services$14.11 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
6 suppliers22 claims22 services$44.91 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
6 suppliers14 claims14 services$14.39 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 8

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

Clinic/Center (Federally Qualified Health Center (FQHC))
9460 NO NAME UNO, SUITE 110
GILROY, CA 95020
Pharmacy (Community/Retail Pharmacy)
9460 NO NAME UNO, SUITE 100
GILROY, CA 95020
Obstetrics & Gynecology
9460 NO NAME UNO, #245
GILROY, CA 95020
Dermatology
9460 NO NAME UNO, SUITE 210
GILROY, CA 95020
Family Medicine
9460 NO NAME UNO, #115
GILROY, CA 95020
Clinic/Center (Ambulatory Surgical)
9460 NO NAME UNO, SUITE 130
GILROY, CA 95020
Physical Therapist
9460 NO NAME UNO, SUITE 140
GILROY, CA 95020
Internal Medicine (Gastroenterology)
9460 NO NAME UNO, SUITE 130
GILROY, CA 95020

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 Smitha Kumar's NPI number?

The NPI number for Smitha Kumar is 1619965688. It was assigned to this individual provider in the NPPES registry on October 12, 2005.

Where is Smitha Kumar located?

Smitha Kumar practices at 9460 No Name Uno 115, Gilroy, CA 95020. The listed phone number is (408) 842-3133.

What is Smitha Kumar's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Smitha Kumar enrolled in Medicare?

Yes. Smitha 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.

When was this NPI record last updated?

The NPPES record for Smitha Kumar was last updated on March 4, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.