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MR. PANKAJ KUMAR MD
NPI 1639279094
Internal Medicine in Richmond, IN

Active since September 25, 2006PECOS EnrolledAccepts Medicare Assignment
1100 REID PKWY, RICHMOND, IN 47374(765) 983-3492(765) 983-7958 Get Directions Write a Review

NPPES record last updated: May 14, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 14, 2021, Nov 5, 2020, Jul 13, 2020 (3 updates tracked since 2020).

About Mr. Pankaj Kumar Md NPPES

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

MR. PANKAJ KUMAR MD (NPI 1639279094) is an individual internal medicine provider in Richmond, Indiana, licensed in Indiana (01040839) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Reid Health, and is a graduate of Other (1980).

NPPES Registry Identity

NPI1639279094
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameMR. PANKAJ KUMARCredential: MD
Location Address1100 REID PKWYRichmond, IN 47374-1157
Mailing Address1100 Reid Parkway, Medical Staff ServiceRichmond, IN 47374 · (765) 935-5331 · Fax (765) 983-3219
Phone(765) 983-3492
Fax(765) 983-7958
Sole ProprietorNo
Medical School CMSOtherGraduated 1980
Enumeration DateSeptember 25, 2006
Last NPPES UpdateMay 14, 20213 updates tracked since enumeration
NPPES CertifiedMay 14, 2021
✔ NPI 1639279094 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IN · 01040839
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.
1100 REID PKWY, Richmond, IN 47374
Open in Google Maps ↗

Other Identifiers 7

Medicaid100257230AIN
Other110058501IN · Rr Medicare
Other903830YIN · Reid Hospital-ekg
Other000000347061IN · Anthem Bcbs Provider Pin
Other000000109079IN · Blue Shield-reid Hospital
Medicaid100257230IN
Other1639279094IN · Pecos

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.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

Mr. Pankaj 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 ID6608836606
PECOS Enrollment IDI20041014000221
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 3

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 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.
74 services40 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.
49 services48 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.
27 services19 patients

Hospital Affiliations CMS Care Compare

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

Reid Health

Acute Care Hospitals · Richmond, IN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150048
Location1100 Reid PkwyRichmond, IN 47374 · Wayne County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 47374 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
$122.49 typical visit price
range $53.07 – $161.76
Typical copayment $30.62 (range $13.26 – $40.44)
Most-billed visit code 99204
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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

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.
62%8,776 patients2/55-star benchmark: 100%
Provide Patient Access
For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…
69%1,159 patients3/55-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 10

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
2 suppliers11 claims11 services$46.36 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
2 suppliers14 claims14 services$67.32 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
2 suppliers14 claims14 services$22.68 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
2 suppliers22 claims125 services$2.55 avg. paid by Medicare
Water chamber for humidifier, used with positive airway pressure device, replacement, each A7046
DME-Other DME · category DE001N
2 suppliers12 claims12 services$12.65 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers99 claims99 services$19.28 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.

JUSTIN VARGHESE
Internal Medicine
1100 REID PKWY
RICHMOND, IN 47374
Wayne County (765) 983-3000
MALLORY J CROSS PA
Student in an Organized Health Care Education/Training Program
1100 REID PKWY
RICHMOND, IN 47374
Wayne County (765) 983-3000
DR. JOHN E MCGINTY IV M.D.
Internal Medicine (Cardiovascular Disease)
1100 REID PKWY, SUITE 210
RICHMOND, IN 47374
Wayne County (765) 962-1337
THOMAS P. GLYNN JR. M.D.
Radiology (Diagnostic Radiology)
1100 REID PKWY
RICHMOND, IN 47374
Wayne County (765) 983-3000
SADIA KHAN MD
Student in an Organized Health Care Education/Training Program
1100 REID PKWY
RICHMOND, IN 47374
Wayne County (765) 983-3822
DR. TYLER BROOKS FREDENBURG MD
Radiology (Diagnostic Radiology)
1100 REID PKWY
RICHMOND, IN 47374
Wayne County (765) 983-3164
AHMAD S KHATRI MD
Family Medicine
1100 REID PKWY
RICHMOND, IN 47374
Wayne County (765) 983-3492
SHARON SMITH LAT, ATC
Specialist/Technologist (Athletic Trainer)
1100 REID PKWY
RICHMOND, IN 47374
Wayne County (765) 983-3000

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 Pankaj Kumar's NPI number?

The NPI number for Pankaj Kumar is 1639279094. It was assigned to this individual provider in the NPPES registry on September 25, 2006.

Where is Pankaj Kumar located?

Pankaj Kumar practices at 1100 Reid Pkwy, Richmond, IN 47374. The listed phone number is (765) 983-3492.

What is Pankaj Kumar's specialty?

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

Is Pankaj Kumar enrolled in Medicare?

Yes. Pankaj 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.

What insurance does Pankaj Kumar accept?

Health plans from CareSource list Pankaj Kumar 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 Pankaj Kumar affiliated with any hospitals?

According to CMS data, Pankaj Kumar is affiliated with Reid Health.

When was this NPI record last updated?

The NPPES record for Pankaj Kumar was last updated on May 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.