2026 NPPES data Pulmonary Disease Physician NPI 1497720635 MD
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AWANI KUMAR, MD

Pulmonary Disease Physician in TOMS RIVER, New Jersey. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.

Federal data — no proprietary rating. PlainDoctor publishes the actual CMS NPPES and Medicare records — NPI registration, specialty, practice location, and prescribing data — without a composite score or editorial opinion on top. Every field traces to a federal source.
Prescribing volume
3K
Medicare Part D claims · 460 beneficiaries · Pulmonary Disease Physician avg: 1K
Generic prescribing
46%
generic claims · 54% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
15.8992/100
▼ 67 pts below national avg 83.1 · [object Object]
Industry payments
$176.81
5 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

AWANI KUMAR, MD reported a CMS MIPS final score of 15.8992/100 — below the 83.1 national average — and filed 3,274 Medicare Part D claims in 2023.

15.8992/100
MIPS score · -67 vs avg
3K
Part D claims, 2023
46%
generic prescribing
Likely
board-certified (heuristic)

Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) — no proprietary rating or editorial opinion is applied.

AWANI KUMAR, MD's MIPS score vs every scored U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023 — the federal quality measure

16 2nd percentile higher than 2% of 477,587 scored providers

0–10: 8,684 scored providers (2%). Below this entry. 10–20: 3,008 scored providers (1%). This entry sits in this band. 20–30: 3,069 scored providers (1%). Above this entry. 30–40: 2,746 scored providers (1%). Above this entry. 40–50: 2,928 scored providers (1%). Above this entry. 50–60: 5,882 scored providers (1%). Above this entry. 60–70: 13,906 scored providers (3%). Above this entry. 70–80: 118,074 scored providers (25%). Above this entry. 80–90: 129,887 scored providers (27%). Above this entry. 90–100: 189,403 scored providers (40%). Above this entry. This provider 0 100 every MIPS-scored clinician, bucketed by value

Each bar is a band; taller bars hold more scored providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.

Source CMS Merit-based Incentive Payment System (MIPS) · 2023

Board certification likely (heuristic — not verified)

AWANI KUMAR, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 1 hospital affiliation — signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).

What does the federal data show about AWANI KUMAR, MD?

Below national average

NPI registry status

Active

Issued 02/21/2006

NPI 1497720635

Primary specialty

Pulmonary Disease Physician

Mid-sized

9,271 US NPIs in this specialty

Medicare Part D claims

3,274 125% vs specialty avg

2023 prescription claims

Specialty avg: 1,457

MIPS final score

15.8992/100 67.20079999999999% pts

Penalty band band

vs 83.1 national avg

Specialty distribution in New Jersey

How Pulmonary Disease Physician compares to other specialties among New Jersey providers

New Jersey providers

Pulmonary Disease Physician share within New Jersey

1. Pulmonary Disease Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Pulmonary Disease Physician share within New Jersey

Medicare quality performance — MIPS

AWANI KUMAR, MD's 2023 MIPS final score plotted against the Pulmonary Disease Physician national average

Below national average
MIPS Final Score
15.8992/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Pulmonary Disease Physician) — 15.8992/100 vs national avg 83.1

0%100%National avg83%15.9%
MIPS final score (Pulmonary Disease Physician) — 15.8992/100 vs national avg 83.1

The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.

Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).

AWANI KUMAR, MD appears in the CMS NPPES registry as a Pulmonary Disease Physician provider holding MD credentials at 780 HWY 37 W, TOMS RIVER, NJ, 08755, with a listed phone of (732) 341-3500. NPI 1497720635 was issued on 02/21/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what KUMAR most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.

Medicare Part D records for calendar year 2023 show 3,274 prescription claims written by this provider, covering 460 Medicare beneficiaries and totaling roughly $992K in drug spend, split 54% brand-name and 46% generic by claim count. These figures capture only Medicare Part D — commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 15.8992/100 for the 2023 performance year (Quality 0, Cost 52.9973), compared with the national average of 83.1.

Pulmonary Disease Physician is a mid-sized specialty nationwide, with 9,271 enrolled providers across 53 states and an average of 1,457 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist — always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.

Practice Address

780 HWY 37 W
TOMS RIVER, NJ 08755

Provider Details

NPI 1497720635
Specialty Pulmonary Disease Physician
Credentials MD
Gender Male
NPI Issued 02/21/2006

CMS Quality Score (MIPS)

Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.

15.8992
Final Score
Avg: 83.1
0
Quality
52.9973
Cost

Reporting: Individual

Hospital and facility affiliations

Facilities where AWANI KUMAR, MD bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" — a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.

AWANI KUMAR, MD, PC
TOMS RIVER, NJ

Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).

Industry payments received (2024) — CMS Open Payments transparency data

The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for AWANI KUMAR, MD. Source: openpaymentsdata.cms.gov.

Total received

$177

Largest payer

Becton, Dickinson and Company

Most common payment type

Food and Beverage

Industry payments are not necessarily indicators of bias — they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.

Brand vs generic prescribing mix · Brand-heavy

AWANI KUMAR, MD — brand share 54.0%
Specialty average (est.)

54% brand-name claims vs 46% generic, on 3,274 2023 Medicare Part D claims.

The federal Medicare Part D Generic Dispensing Rate national benchmark sits near 90% generic / 10% brand for primary-care prescribers, per CMS Office of the Actuary 2024 estimates. Higher brand share is common in specialty prescribing where generic equivalents are not available.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

3,274
Total Claims
$992K
Total Drug Cost
460
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
4,836
Total Day Supply
138,473
Brand vs Generic
54% brand / 46% generic
Brand Drug Cost
$927K
Antibiotic Claims
86

Patient Demographics

Average Patient Age
75.7 years
Avg HCC Risk Score
1.94
Gender Split
63% female / 37% male
Age Distribution
<65: 45, 65-74: 152, 75-84: 194, 85+: 69

Top Prescribed Drugs (Medicare Part D)

Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.

What AWANI KUMAR, MD prescribes most

Top Medicare Part D drugs by claim count, 2023

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2023
Drug Claims
Breo Ellipta
Fluticasone/Vilanterol
596
Albuterol Sulfate Hfa
Albuterol Sulfate
460
Montelukast Sodium
295
Prednisone
233
Trelegy Ellipta
Fluticasone/Umeclidin/Vilanter
213
Symbicort
Budesonide/Formoterol Fumarate
195
Pantoprazole Sodium
95
Ventolin Hfa
Albuterol Sulfate
91
Advair Diskus
Fluticasone Propion/Salmeterol
87
Fluticasone Propionate
76

* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.

Pulmonary Disease Physician Overview

How AWANI KUMAR, MD fits within the Pulmonary Disease Physician landscape nationally.

9,271
Pulmonary Disease Physician Providers in US
53
States with Pulmonary Disease Physician
1,457
Avg Claims per Provider

AWANI KUMAR, MD's 3,274 claims are above the specialty average of 1,457.

Nearby Pulmonary Disease Physician Providers in New Jersey

Other clinicians with the same primary specialty enrolled in New Jersey, drawn from the same CMS NPPES roster as KUMAR.

Compare Pulmonary Disease Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is AWANI KUMAR, MD's specialty?
AWANI KUMAR, MD specializes in Pulmonary Disease Physician and practices in TOMS RIVER, New Jersey. Credentials: MD.
How much does AWANI KUMAR, MD prescribe under Medicare Part D?
In 2023, AWANI KUMAR, MD wrote 3,274 Medicare Part D claims totaling $992K in drug costs for 460 beneficiaries.
What is AWANI KUMAR, MD's Medicare quality score?
AWANI KUMAR, MD has a CMS MIPS Final Score of 15.8992/100 (Quality: 0, Cost: 52.9973). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is AWANI KUMAR, MD located?
AWANI KUMAR, MD is located at 780 HWY 37 W, TOMS RIVER, NJ, 08755. Phone: (732) 341-3500.
What is AWANI KUMAR, MD's NPI number?
AWANI KUMAR, MD's National Provider Identifier (NPI) is 1497720635, issued on 02/21/2006.
Does AWANI KUMAR, MD prescribe more brand-name or generic drugs?
AWANI KUMAR, MD's prescribing is 54% brand-name and 46% generic drugs by claim count, with $927K in brand drug costs.
How many Pulmonary Disease Physician providers are there in the US?
There are 9,271 Pulmonary Disease Physician providers across 53 states in the US. The average Pulmonary Disease Physician provider writes 1,457 Medicare Part D claims per year.
What drugs does AWANI KUMAR, MD prescribe most often?
Based on 2023 Medicare Part D data, AWANI KUMAR, MD's most frequently prescribed drugs include Breo Ellipta, Albuterol Sulfate Hfa, Montelukast Sodium. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does AWANI KUMAR, MD accept Medicare?
AWANI KUMAR, MD appears in CMS Medicare data with 3,274 Part D claims and 460 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify AWANI KUMAR, MD's credentials?
AWANI KUMAR, MD's NPI is 1497720635 with credentials MD. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.

Data Sources

Provider Directory
CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
Specialty Classification
NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
Prescribing Data
CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
Quality Performance
CMS Merit-based Incentive Payment System (MIPS) — 2023 performance year.
Limitations
Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.

See our complete data methodology for details on how we collect and process government data.

Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).

Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology