SHEETAL KUMAR DO
NPI 1942682133
Internal Medicine - Hematology & Oncology in Providence, RI

Q: What is Sheetal Kumar's NPI number?

The NPI number for Sheetal Kumar is 1942682133. It was assigned to this individual provider in the NPPES registry on June 24, 2015.

Q: What is Sheetal Kumar's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Q: When was this NPI record last updated?

The NPPES record for Sheetal Kumar was last updated on December 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.

Active since June 24, 2015PECOS EnrolledAccepts Medicare Assignment

81.72/100

CMS Quality Rating

164 SUMMIT AVE, PROVIDENCE, RI 02906(401) 793-2920(401) 793-2859 Get Directions Write a Review

NPPES record last updated: December 3, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 3, 2024, Nov 16, 2022 (2 updates tracked since 2022).

On this page

About Sheetal Kumar Do NPPES

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

SHEETAL KUMAR DO (NPI 1942682133) is an individual hematology & oncology provider in Providence, Rhode Island, licensed in Rhode Island (DO01409) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS, is affiliated with Rhode Island Hospital, and is a graduate of Lake Erie Col Of Osteo Med At Seton Hill Univ (2015).

NPPES Registry Identity

NPI1942682133

Entity TypeIndividualFemale

Primary Taxonomy207RH0003X

Provider Legal NameSHEETAL KUMARCredential: DO

Location Address164 SUMMIT AVEProvidence, RI 02906-2853

Mailing Address117 Ellenfield St Ste 101Providence, RI 02905-4541

Phone(401) 793-2920

Fax(401) 793-2859

Sole ProprietorYes

Medical School CMSLake Erie Col Of Osteo Med At Seton Hill UnivGraduated 2015

Enumeration DateJune 24, 2015

Last NPPES UpdateDecember 3, 20242 updates tracked since enumeration

NPPES CertifiedDecember 3, 2024

✔ NPI 1942682133 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0003X

License✔ Licensed in RI · DO01409

Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

164 SUMMIT AVE, Providence, RI 02906

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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

Sheetal Kumar Do 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 ID8729380324

PECOS Enrollment IDI20250108002678

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 6

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.

133 services66 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

65 services35 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

59 services36 patients

Blood test, comprehensive group of blood chemicals 80053

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

49 services30 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

19 services19 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.

18 services14 patients

Hospital Affiliations CMS Care Compare 2

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

Rhode Island Hospital

Acute Care Hospitals · Providence, RI

3/5 CMS rating

OwnershipTribal

CMS Certification Number410007

Location593 Eddy StreetProvidence, RI 02903 · Providence County

Emergency services

The Miriam Hospital

Acute Care Hospitals · Providence, RI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number410012

Location164 Summit AvenueProvidence, RI 02906 · Providence County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02906 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

$177.03 typical visit price

range $58.57 – $177.03

Typical copayment $44.25 (range $14.64 – $44.25)

Most-billed visit code 99205

Established Patient

$103.10 typical visit price

range $18.92 – $144.38

Typical copayment $25.77 (range $4.73 – $36.09)

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.

81.72/100

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

Scored as part of a group practice

Quality

69.86

Promoting Interoperability

100

Improvement Activities

Cost

59.73

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.

MRS. HALINA KUC-MAZGAJ

Nurse Practitioner (Family)

164 SUMMIT AVE, THE MIRIAM HOSPITAL
PROVIDENCE, RI 02906

Providence County (401) 793-3902

KARL HERMAN M.D.

Internal Medicine

164 SUMMIT AVE, FAIN BLDG.
PROVIDENCE, RI 02906

Providence County (401) 793-4489

MUHAMMAD BAIG M.D.

Internal Medicine (Cardiovascular Disease)

164 SUMMIT AVE, FAIN BLDG
PROVIDENCE, RI 02906

Providence County (401) 793-4489

MS. LEANNE LAPARLE LICSW

Social Worker (Clinical)