DR. PRIYA KUMARAGURU M.D.
NPI 1902062862
Family Medicine in Alton, IL

Q: What is Priya Kumaraguru's NPI number?

The NPI number for Priya Kumaraguru is 1902062862. It was assigned to this individual provider in the NPPES registry on July 31, 2008.

Q: What is Priya Kumaraguru's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Priya Kumaraguru was last updated on March 9, 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 July 31, 2008PECOS EnrolledAccepts Medicare Assignment

2 SAINT ANTHONYS WAY, SUITE 205, ALTON, IL 62002(618) 462-2222(618) 463-5004 Get Directions Write a Review

NPPES record last updated: March 9, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Priya Kumaraguru M.d. NPPES

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

DR. PRIYA KUMARAGURU M.D. (NPI 1902062862) is an individual family medicine provider in Alton, Illinois, licensed in Illinois (036127459) and active in the NPI registry since July 2008. She is enrolled in Medicare PECOS, is affiliated with Alton Memorial Hospital, and maintains a secondary practice location in Saint Louis.

NPPES Registry Identity

NPI1902062862

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. PRIYA KUMARAGURUCredential: M.D.

Location Address2 SAINT ANTHONYS WAY, SUITE 205Alton, IL 62002-4569

Mailing Address2 Saint Anthonys Way, Suite 205Alton, IL 62002-4569 · (618) 462-2222 · Fax (618) 462-1150

Phone(618) 462-2222

Fax(618) 463-5004

Sole ProprietorNo

Medical School CMSOtherGraduated 2005

Enumeration DateJuly 31, 2008

Last NPPES UpdateMarch 9, 2023

NPPES CertifiedMarch 9, 2023

✔ NPI 1902062862 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in IL · 036127459

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.

2 SAINT ANTHONYS WAY, Alton, IL 62002

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Secondary Practice Location 1

Location 19759 Manchester RdSaint Louis, MO 63119-1346 · Phone (314) 781-4922

Other Identifiers 1

OtherP01013993IL · Railroad Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan 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. Priya Kumaraguru 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 ID4385816834

PECOS Enrollment IDI20221121001036

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 2

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.

78 services40 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.

23 services23 patients

Hospital Affiliations CMS Care Compare 5

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

Alton Memorial Hospital

Acute Care Hospitals · Alton, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140002

LocationOne Memorial DriveAlton, IL 62002 · Madison County

Emergency services Birthing friendly

Barnes Jewish Hospital

Acute Care Hospitals · Saint Louis, MO

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number260032

LocationOne Barnes-Jewish Hospital PlazaSaint Louis, MO 63110 · St. Louis City County

Emergency services Birthing friendly

Ssm St Clare Health Center

Acute Care Hospitals · Fenton, MO

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260081

Location1015 BowlesFenton, MO 63026 · Jefferson County

Emergency services Birthing friendly

Ssm Health St Mary's Hospital - St Louis

Acute Care Hospitals · Richmond Heights, MO

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260091

Location6420 Clayton RdRichmond Heights, MO 63117 · St. Louis County

Emergency services Birthing friendly

Ssm Health Depaul Hospital St Louis

Acute Care Hospitals · Bridgeton, MO

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number260104

Location12303 Depaul DriveBridgeton, MO 63044 · St. Louis County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62002 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

$88.44 typical visit price

range $56.28 – $173.35

Typical copayment $22.11 (range $14.07 – $43.33)

Most-billed visit code 99203

Established Patient

$99.71 typical visit price

range $17.51 – $139.99

Typical copayment $24.92 (range $4.37 – $34.99)

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.

Referred Medical Equipment & Supplies CMS DME claims 9

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

10 suppliers35 claims72 services$5.86 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

7 suppliers21 claims22 services$1.03 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

2 suppliers14 claims19 services$1.58 avg. paid by Medicare

Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each E0955

DME-Wheelchairs · category DD021N

2 suppliers45 claims45 services$13.37 avg. paid by Medicare

Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory E1028

DME-Wheelchairs · category DD021N

2 suppliers57 claims61 services$13.93 avg. paid by Medicare

Manual adult size wheelchair, includes tilt in space E1161

DME-Wheelchairs · category DD000N

2 suppliers45 claims45 services$181.32 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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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. EDWARD B BLAIR JR. M.D.

Internal Medicine

2 SAINT ANTHONYS WAY, SUITE 205
ALTON, IL 62002

Madison County (618) 462-2222

PHILIP D KANNEL DO

Otolaryngology

2 SAINT ANTHONYS WAY, SUITE 305
ALTON, IL 62002

Madison County (618) 462-2277

DR. JOHN EDWARD LINDSAY D.P.M.

Podiatrist (Foot & Ankle Surgery)

2 SAINT ANTHONYS WAY, SUITE 305
ALTON, IL 62002

Madison County (618) 463-0227

ALICE MARIE HUTCHASON FNP

Nurse Practitioner (Family)

2 SAINT ANTHONYS WAY
ALTON, IL 62002

Madison County (618) 474-6233

WONIL TAE MD

Internal Medicine (Endocrinology, Diabetes & Metabolism)

2 SAINT ANTHONYS WAY
ALTON, IL 62002

Madison County (618) 642-2222

KATE A SMITH MPAS

Physician Assistant

2 SAINT ANTHONYS WAY, SUITE 305
ALTON, IL 62002

Madison County (618) 465-9024

DR. KEVIN D BOYD D.O.

Family Medicine

2 SAINT ANTHONYS WAY, SUITE 205
ALTON, IL 62002

Madison County (618) 462-2222

DR. CLIFFORD GLENN MARTIN M.D.

Obstetrics & Gynecology

2 SAINT ANTHONYS WAY
ALTON, IL 62002

Madison County (618) 462-2222

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 Priya Kumaraguru's NPI number?

The NPI number for Priya Kumaraguru is 1902062862. It was assigned to this individual provider in the NPPES registry on July 31, 2008.

Where is Priya Kumaraguru located?

Priya Kumaraguru practices at 2 Saint Anthonys Way Suite 205, Alton, IL 62002. The listed phone number is (618) 462-2222.

What is Priya Kumaraguru's specialty?

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

Is Priya Kumaraguru enrolled in Medicare?

Yes. Priya Kumaraguru 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 Priya Kumaraguru accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 4 other insurers list Priya Kumaraguru 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 Priya Kumaraguru affiliated with any hospitals?

According to CMS data, Priya Kumaraguru is affiliated with Alton Memorial Hospital, Barnes Jewish Hospital, Ssm St Clare Health Center, Ssm Health St Mary's Hospital - St Louis and Ssm Health Depaul Hospital St Louis.

When was this NPI record last updated?

The NPPES record for Priya Kumaraguru was last updated on March 9, 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.