ASHWANI KUMAR MD
NPI 1851528509
Hospitalist in Madisonville, KY

Q: What is Ashwani Kumar's NPI number?

The NPI number for Ashwani Kumar is 1851528509. It was assigned to this individual provider in the NPPES registry on June 19, 2009.

Q: What is Ashwani Kumar's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Q: When was this NPI record last updated?

The NPPES record for Ashwani Kumar was last updated on July 17, 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 June 19, 2009PECOS EnrolledAccepts Medicare Assignment

81.75/100

CMS Quality Rating

200 CLINIC DR, MADISONVILLE, KY 42431(270) 825-7200 Get Directions Write a Review

NPPES record last updated: July 17, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 17, 2023, Aug 18, 2020 (2 updates tracked since 2020).

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About Ashwani Kumar Md NPPES

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

ASHWANI KUMAR MD (NPI 1851528509) is an individual hospitalist provider in Madisonville, Kentucky, licensed in California (A117524) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS and is a graduate of Other (2005).

NPPES Registry Identity

NPI1851528509

Entity TypeIndividualMale

Primary Taxonomy208M00000X

Provider Legal NameASHWANI KUMARCredential: MD

Location Address200 CLINIC DRMadisonville, KY 42431-1661

Mailing Address1100 Butte StRedding, CA 96001-0852 · (530) 244-5388

Phone(270) 825-7200

Sole ProprietorNo

Medical School CMSOtherGraduated 2005

Enumeration DateJune 19, 2009

Last NPPES UpdateJuly 17, 20232 updates tracked since enumeration

NPPES CertifiedJuly 17, 2023

✔ NPI 1851528509 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

License✔ Licensed in CA · A117524

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Also ListedFamily MedicineTaxonomy 207Q00000X · License R2140 (KY)

200 CLINIC DR, Madisonville, KY 42431

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Other Identifiers 1

OtherP00928226KY · Railroad Medicare

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

Ashwani 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 ID8426172974

PECOS Enrollment IDI20120827000360

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

Medicare enrollment records show Ashwani Kumar reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Galen Inpatient Physicians Inc.

1,647 mi

Internal Medicine

1150 N INDIAN CANYON DR
Palm Springs, CA 92262

Reassigned Medicare billing, California enrollment
962 clinicians in this Medicare group

NPI 1316037021 (760) 323-6511

Vituity Hospitalists PC

1,775 mi

Hospitalist

1303 E HERNDON AVE
Fresno, CA 93720

Reassigned Medicare billing, California enrollment
182 clinicians in this Medicare group

NPI 1285111658 (559) 450-3000

Shasta Regional Medical Group, Inc

1,876 mi

Family Medicine

50 ALAMO AVE
Weed, CA 96094

Reassigned Medicare billing, California enrollment
63 clinicians in this Medicare group

NPI 1588048680 (530) 605-4263

Ashwani Kumar MD A Professional Corporation

1,879 mi

Family Medicine

3550 CHURN CREEK RD
Redding, CA 96002

Reassigned Medicare billing, California enrollment

NPI 1992403349 (702) 453-3799

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 12

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 nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

869 services235 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.

683 services322 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

637 services283 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.

482 services412 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

424 services364 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.

233 services227 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.

227 services134 patients

Nursing facility discharge day management, 30 minutes or less 99315

Nursing facility discharge day management involves organizing your transition from the nursing facility to your home or another facility. This service, taking 30 minutes or less, includes finalizing medical instructions, arranging follow-up care, and answering any questions.

191 services175 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.

129 services129 patients

Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310

A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.

74 services60 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

43 services29 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

19 services19 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 42431 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

$122.77 typical visit price

range $52.76 – $162.27

Typical copayment $30.69 (range $13.19 – $40.56)

Most-billed visit code 99204

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

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.

81.75/100

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

Scored as part of a group practice

Quality

70.65

Promoting Interoperability

Improvement Activities

Cost

79.21

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…

95%56 patients4/55-star benchmark: 100%

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

17%217 patients1/55-star benchmark: 85%

Preventive Care and Screening: Influenza Immunization

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

11%201 patients1/55-star benchmark: 88%

Use of High-Risk Medications in the Elderly

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.

Lower rates are better for this measure.

Patients 2+: 0% · 242 patients

2%242 patients4/55-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 11

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

Walker, folding, wheeled, adjustable or fixed height E0143

DME-Other DME · category DE000N

2 suppliers24 claims24 services$53.15 avg. paid by Medicare

Seat attachment, walker E0156

DME-Other DME · category DE000N

2 suppliers15 claims15 services$15.69 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

2 suppliers59 claims59 services$49.11 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

3 suppliers30 claims30 services$15.38 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

2 suppliers22 claims22 services$5.17 avg. paid by Medicare

Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) E0630

DME-Other DME · category DE000N

2 suppliers29 claims29 services$35.51 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.

HEATHER RAE PENDLEY

Case Manager/Care Coordinator