RATNESH KUMAR MBBS,MD
NPI 1952544918
Pediatrics in Hoffman Estates, IL

NPI Status: Active since April 07, 2009

Contact Information

1585 BARRINGTON RD
SUITE 601-A , DOCTOR'S BUILDING#2
HOFFMAN ESTATES, IL
ZIP 60169
Phone: (847) 884-5911

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  • Individual
  • Male
  • Years of Experience 20
  • Pediatrics
  • Accepts Insurance
  • May Accept Medicare Approved Payment
  • PECOS Enrolled

About RATNESH KUMAR

This page provides the complete NPI Profile along with additional information for Ratnesh Kumar, a pediatrician established in Hoffman Estates, Illinois with a medical specialization in Pediatrics and more than 20 years of experience. The healthcare provider is registered in the NPI registry with number 1952544918 assigned on April 2009. The practitioner's primary taxonomy code is 208000000X with license number 036.140474 (IL). The provider is registered as an individual and his NPI record was last updated 4 years ago.

NPI
1952544918
Provider Name
RATNESH KUMAR MBBS,MD
Gender
Male
Entity Type
Individual
Location Address
1585 BARRINGTON RD SUITE 601-A , DOCTOR'S BUILDING#2 HOFFMAN ESTATES, IL 60169
Location Phone
(847) 884-5911
Mailing Address
1S210 SUMMIT AVE OAKBROOK TERRACE, IL 60181
Mailing Phone
(630) 282-6002
Mailing Fax
Medical School Name
OTHER
Graduation Year
2006
Is Sole Proprietor?
Yes
Enumeration Date
04-07-2009
Last Update Date
02-07-2022
Code Navigator

A pediatrician like Ratnesh Kumar is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pediatrics

Taxonomy Code
208000000X
Type
Allopathic & Osteopathic Physicians
License No.
036.140474
License State
IL
Taxonomy Description
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1208000000XAllopathic & Osteopathic Physicians

Pediatrics

053520 (CT)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Principal Bronze HSA - EPO
  • Principal Bronze HSA + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Ratnesh Kumar is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.

Ratnesh Kumar is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 1355606559

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20180517000115

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Maybe

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)

A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.

This service was performed 31 times for 29 patients

Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19), influenza virus types a and b, and respiratory syncytial virus

This test identifies if you have COVID-19, influenza A or B, or respiratory syncytial virus. It uses a multiplex amplified probe technique, which amplifies and detects specific genetic material of the viruses, helping in accurate diagnosis.

This service was performed 52 times for 51 patients

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 79 times for 68 patients

Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within

This is a test to detect the COVID-19 virus. It uses a technique that amplifies the virus's genetic material (DNA or RNA) for detection. High throughput technologies are used for rapid and large-scale testing. The procedure is completed within a set time frame.

This service was performed 17 times for 16 patients

Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r

This is a test for COVID-19. It uses high-tech methods to find the virus's genetic material in your body. The amplified probe technique helps detect the virus even in small amounts. This is crucial for early detection and effective treatment.

This service was performed 17 times for 16 patients

Injection of drug or substance under skin or into muscle

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

This service was performed 23 times for 22 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 68 times for 68 patients

Urinalysis, manual test

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

This service was performed 18 times for 18 patients

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 60169 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $94.06
  • Minimum New Patient Price $60.08
  • Maximum New Patient Price $183.39
  • Average New Patient Copayment $23.51
  • Minimum New Patient Copayment $15.02
  • Maximum New Patient Copayment $45.84

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $105.7
  • Minimum Established Patient Price $18.97
  • Maximum Established Patient Price $148.12
  • Average Established Patient Copayment $26.42
  • Minimum Established Patient Copayment $4.74
  • Maximum Established Patient Copayment $37.03

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Ratnesh Kumar is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL25 NORTH WINFIELD ROAD
WINFIELD, IL 60190
(630) 682-1600Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1952544918, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
9
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
2
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
4
Unchanged
Pos 7
4
Doubled → 8
Pos 8
9
Unchanged
Pos 9
1
Doubled → 2
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 5 → 10 → 1 4 → 8 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 9 + 1 + 0 + 2 + 1 + 0 + 4 + 8 + 9 + 2 + 24 = 62

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1952544918.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Optometrist
1585 BARRINGTON RD, SUITE 404
HOFFMAN ESTATES, IL 60169
Obstetrics & Gynecology (Reproductive Endocrinology)
1585 BARRINGTON RD, SUITE 401
HOFFMAN ESTATES, IL 60169
Orthopaedic Surgery
1585 BARRINGTON RD, SUITE 101
HOFFMAN ESTATES, IL 60169
Podiatrist
1585 BARRINGTON RD, SUITE 603
HOFFMAN ESTATES, IL 60169
Physician Assistant (Medical)
1585 BARRINGTON RD, SUITE 505
HOFFMAN ESTATES, IL 60169
Ophthalmology
1585 BARRINGTON RD
HOFFMAN ESTATES, IL 60169
Dentist (General Practice)
1585 BARRINGTON RD, STE 106
HOFFMAN ESTATES, IL 60169
Dentist (Endodontics)
1585 BARRINGTON RD, SUITE 301, DR BLD 2
HOFFMAN ESTATES, IL 60169
Dentist (Oral and Maxillofacial Surgery)
1585 BARRINGTON RD, SUITE 301, DR BLD 2
HOFFMAN ESTATES, IL 60169
Dentist (General Practice)
1585 BARRINGTON RD, SUITE 301, DR BUILDING 2
HOFFMAN ESTATES, IL 60169
Dentist (Oral and Maxillofacial Surgery)
1585 BARRINGTON RD, SUITE #301, DR BUILDING 2
HOFFMAN ESTATES, IL 60169
General Acute Care Hospital
1585 BARRINGTON RD
HOFFMAN ESTATES, IL 60169
Obstetrics & Gynecology (Gynecology)
1585 BARRINGTON RD, SUITE 605
HOFFMAN ESTATES, IL 60169
Obstetrics & Gynecology (Gynecology)
1585 BARRINGTON RD, SUITE 605
HOFFMAN ESTATES, IL 60169
Surgery
1585 BARRINGTON RD, SUITE 501
HOFFMAN ESTATES, IL 60169
Specialist
1585 BARRINGTON RD, SUITE 606
HOFFMAN ESTATES, IL 60169
Specialist/Technologist (Athletic Trainer)
1585 BARRINGTON RD
HOFFMAN ESTATES, IL 60169
Physician Assistant
1585 BARRINGTON RD, 605
HOFFMAN ESTATES, IL 60169
Internal Medicine
1585 BARRINGTON RD, DOCTORS BUILDING 2 - SUITE 501
HOFFMAN ESTATES, IL 60169
Physical Therapist
1585 BARRINGTON RD, SUITE # 101
HOFFMAN ESTATES, IL 60169

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1952544918, enumerated as an "individual" on April 07, 2009.

The provider is located at 1585 BARRINGTON RD SUITE 601-A , DOCTOR'S BUILDING#2 HOFFMAN ESTATES, IL 60169 and the phone number is (847) 884-5911.

Pediatrics with taxonomy code 208000000X.

The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter Health. Please consult your insurance carrier or call the provider to verify.

Ratnesh Kumar is affiliated with: NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL.