Active NPI 1548743388 Individual Practitioner Female Practitioner

Hemali Kumar , NP

Nurse Practitioner • Elgin, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Hemali Kumar, NP is a certified Nurse Practitioner practicing in Elgin, IL. With approximately 9 years of clinical experience since completing medical education in 2017, Hemali Kumar delivers high-quality medical care to the local community at 745 FLETCHER DR STE 202.

Hemali Kumar is affiliated with Illinois Gastroenterology Group Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include subsequent hospital care with moderate levelof medical decision making, if using time, at least, established patient outpatient office visit, new patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

745 Fletcher Dr Ste 202

Elgin, IL 601234749

Telephone 8478881300

Fax 8478881341

Associated Practice Facility / Clinic

🏢 Elgin Gastroenterology Sc Facility NPI 1932291101

Medicare Profile & Education

Medical School

Other

Graduation Year

2017

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Elgin, IL

Experienced Practitioner (5-10 Yrs)

Practitioner Clinical Experience

9 Yrs +0.5 yrs vs City Avg

City Avg: 8.5 Yrs

State Avg: 10.4 Yrs

Regional Practice Density

41 Specialists

Practicing in Elgin, IL (4929 Statewide)

Telehealth Adoption Rate

17.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

54.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Kumar (9 Years) 9 Yrs

Elgin Specialty Average (8.5 Years) 8.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	457	240	$200.00	$67.82
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	20	20	$212.00	$111.85
99213 Established patient office or other outpatient visit, typically 15 minutes	15	15	$150.00	$75.20

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	442	262	$200.00	$69.10
99213 Established patient office or other outpatient visit, typically 15 minutes	31	30	$150.00	$78.20
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	21	21	$212.00	$112.96
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	15	15	$328.00	$147.28

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	347	212	$200.00	$62.62
99213 Established patient office or other outpatient visit, typically 15 minutes	91	86	$150.00	$80.36
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	30	30	$328.00	$149.36
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	25	25	$212.00	$114.58
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$250.00	$100.81

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	78	69	$200.00	$62.58
99213 Established patient office or other outpatient visit, typically 15 minutes	63	61	$150.00	$82.42
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	62	59	$212.00	$116.02
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	34	34	$328.00	$149.03
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	19	16	$250.00	$92.04
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$250.00	$99.80

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	39	32	$200.00	$65.02
99213 Established patient office or other outpatient visit, typically 15 minutes	38	38	$150.00	$68.07
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	30	30	$212.00	$95.75
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	29	29	$328.00	$144.39
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	16	16	$250.00	$97.92

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	83	83	$212.00	$96.33
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	61	61	$328.00	$146.79
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	47	41	$200.00	$64.77
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$250.00	$95.80

Medical Specialties & State Licenses

Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License IL 209-017721

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Hospital & Practice Group Affiliations

Illinois Gastroenterology Group Llc

745 Fletcher Dr, Elgin, IL 601234749

Phone: 8478881300