RAHUL KUMAR MD
NPI 1912074964
Internal Medicine - Clinical Cardiac Electrophysiology in Neptune, NJ

Active since November 28, 2006PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
1820 STATE ROUTE 33 STE 4B, NEPTUNE, NJ 07753(732) 776-8500(732) 776-8946 Get Directions Write a Review

NPPES record last updated: February 10, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Rahul Kumar Md NPPES

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

RAHUL KUMAR MD (NPI 1912074964) is an individual clinical cardiac electrophysiology provider in Neptune, New Jersey, licensed in New Jersey (25MA09294000) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS, is affiliated with Riverview Medical Center, and is a graduate of Northwestern University Feinberg Medical School (2002).

NPPES Registry Identity

NPI1912074964
Entity TypeIndividualMale
Primary Taxonomy207RC0001X
Provider Legal NameRAHUL KUMARCredential: MD
Location Address1820 STATE ROUTE 33 STE 4BNeptune, NJ 07753-4860
Mailing Address35 Beaverson Blvd Ste 8cBrick, NJ 08723-7861 · (732) 776-8500 · Fax (732) 776-8946
Fax(732) 776-8946
Sole ProprietorNo
Medical School CMSNorthwestern University Feinberg Medical SchoolGraduated 2002
Enumeration DateNovember 28, 2006
Last NPPES UpdateFebruary 10, 2025
NPPES CertifiedFebruary 10, 2025
NPI 1912074964 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · Clinical Cardiac ElectrophysiologyAllopathic & Osteopathic Physicians
Taxonomy Code207RC0001X
License Licensed in NJ · 25MA09294000
Definition
A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them.
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X · License 25MA09294000 (NJ)
1820 STATE ROUTE 33 STE 4B, Neptune, NJ 07753

Accepted 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

Rahul 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 ID7810915527
PECOS Enrollment IDI20140116001105
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 26

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.
442 services136 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.
352 services271 patients
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.
339 services238 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
323 services242 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
204 services186 patients
Programming of dual lead pacemaker system 93280
Programming of a dual lead pacemaker system is a procedure to adjust your heart's pacemaker settings. This process involves a small device, called a programmer, that communicates with your pacemaker to ensure it's working optimally for your heart's needs.
154 services128 patients

Hospital Affiliations CMS Care Compare 5

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

Riverview Medical Center

Acute Care Hospitals · Red Bank, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310034
LocationOne Riverview PlazaRed Bank, NJ 07701 · Monmouth County
Emergency services Birthing friendly

Community Medical Center

Acute Care Hospitals · Toms River, NJ
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310041
Location99 Rt 37 WestToms River, NJ 08755 · Ocean County
Emergency services Birthing friendly

Ocean Medical Center

Acute Care Hospitals · Brick, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number310052
Location425 Jack Martin BlvdBrick, NJ 08724 · Ocean County
Emergency services Birthing friendly

Jersey Shore University Medical Center

Acute Care Hospitals · Neptune, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310073
Location1945 State Route 33Neptune, NJ 07753 · Monmouth County
Emergency services Birthing friendly

Bayshore Medical Center

Acute Care Hospitals · Holmdel, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310112
Location727 N Beers StHolmdel, NJ 07733 · Monmouth County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07753 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
$140.34 typical visit price
range $61.59 – $185.05
Typical copayment $35.08 (range $15.39 – $46.26)
Most-billed visit code 99204
Established Patient
$107.94 typical visit price
range $20.08 – $150.98
Typical copayment $26.98 (range $5.02 – $37.74)
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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

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…
100%915 patients5/55-star benchmark: 100%
Coronary Artery Disease (CAD): Antiplatelet Therapy
Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease (CAD) seen within a 12 month period who were prescribed aspirin or clopidogrel
91%348 patients4/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%1,760 patients5/55-star benchmark: 100%
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.
0%214 patients1/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
1%495 patients1/55-star benchmark: 98%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%450 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
86%441 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
94%1,388 patients4/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
74%46 patients3/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
99%564 patients4/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
95%441 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
10%441 patients1/55-star benchmark: 79%
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 3

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

Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) A4221
DME-Other DME · category DE017N
1 supplier51 claims51 services$17.68 avg. paid by Medicare
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) A4222
DME-Medical/Surgical Supplies · category DA000N
1 supplier51 claims51 services$34.93 avg. paid by Medicare
Injection, milrinone lactate, 5 mg J2260
Treatment-Injections and Infusions (nononcologic) · category RI026N
1 supplier51 claims2,040 services$1.27 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 10

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

Physician Assistant
1820 STATE ROUTE 33 STE 4B
NEPTUNE, NJ 07753
Internal Medicine (Cardiovascular Disease)
1820 STATE ROUTE 33 STE 4B
NEPTUNE, NJ 07753
Physician Assistant (Medical)
1820 STATE ROUTE 33 STE 4B
NEPTUNE, NJ 07753
Physician Assistant
1820 STATE ROUTE 33 STE 4B
NEPTUNE, NJ 07753
Physician Assistant
1820 STATE ROUTE 33 STE 4B
NEPTUNE, NJ 07753
Physician Assistant
1820 STATE ROUTE 33 STE 4B
NEPTUNE, NJ 07753
Physician Assistant
1820 STATE ROUTE 33 STE 4B
NEPTUNE, NJ 07753
Internal Medicine (Cardiovascular Disease)
1820 STATE ROUTE 33 STE 4B
NEPTUNE, NJ 07753

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 Rahul Kumar's NPI number?

The NPI number for Rahul Kumar is 1912074964. It was assigned to this individual provider in the NPPES registry on November 28, 2006.

Where is Rahul Kumar located?

Rahul Kumar practices at 1820 State Route 33 Ste 4B, Neptune, NJ 07753. The listed phone number is (732) 776-8500.

What is Rahul Kumar's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Clinical Cardiac Electrophysiology, with taxonomy code 207RC0001X.

Is Rahul Kumar enrolled in Medicare?

Yes. Rahul 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 Rahul Kumar accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Rahul 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 Rahul Kumar affiliated with any hospitals?

According to CMS data, Rahul Kumar is affiliated with Riverview Medical Center, Community Medical Center, Ocean Medical Center, Jersey Shore University Medical Center and Bayshore Medical Center.

When was this NPI record last updated?

The NPPES record for Rahul Kumar was last updated on February 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.