Providers
All 25 in TN
SANJEEV KUMAR, MD
NPI 1932381530, individual, Memphis, TN, Obstetrics & Gynecology, Gynecologic Oncology
1
Evidence tier
adjudicated in a public enforcement record
- Adjudicated (sentenced, indicted, convicted) per a Department of Justice release dated February 28, 2025.
- Medicaid paid $707,185 in the last 12 observed months.
score 96 of 100, rank 75, $707K at stake
Public list actions
Medicare revocation effective November 13, 2025, barred from re-enrolling until November 12, 2026
424.535(a)(13) prescribing authority, Practitioner - Obstetrics/Gynecology, TN
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | SANJEEV KUMAR, MD |
| Type | Individual |
| Status | Active |
| NPI issued | December 5, 2007, last updated April 29, 2019 |
| Practice location | 6584 POPLAR AVE, STE 400, Memphis, TN 38138-3687, 901-226-4280 |
| Mailing address | PO BOX 172344, Memphis, TN 38187-2344 |
| Specialties | Obstetrics & Gynecology, Gynecologic Oncology (207VX0201X, primary, license 50367 TN) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 58558 | Biopsy of lining of uterus and/or removal of polyp using an endoscope | $3.6M | 48% | $466 | $1K (top 5% from $2K) | 27th percentile | |
| 76830 | Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina | $847K | 11% | $66 | $54 (top 5% from $126) | 59th percentile | |
| 76856 | Complete ultrasound scan of pelvis | $677K | 9% | $61 | $37 (top 5% from $154) | 67th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $597K | 8% | $61 | $60 (top 5% from $133) | 51st percentile | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $294K | 4% | $90 | $95 (top 5% from $171) | 44th percentile | |
| 57425 | Surgical repair of vaginal defect using an endoscope | $264K | 3% | $1K | too few months to rank | ||
| 99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or morehistory of abuse | $198K | 3% | $87 | $88 (top 5% from $210) | 49th percentile | |
| 58662 | Destruction or removal of ovary or growth of pelvis using an endoscope | $196K | 3% | $610 | too few months to rank |
Medicare Part B 2024, largest codes
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 58558 | Biopsy of lining of uterus and/or removal of polyp using an endoscope | 72 | 52 | $66K | $3K | $1K | 2.2x | 4.7x (90th percentile 18.8x) |
| 76830 | Ultrasound scan of uterus, ovaries, tubes, cervix and pelvic area through vagina | 137 | 91 | $12K | $225 | $106 | 2.1x | 3.4x (90th percentile 6.9x) |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 124 | 75 | $11K | $205 | $118 | 1.7x | 2.3x (90th percentile 3.8x) |
| 76856 | Complete ultrasound scan of pelvis | 139 | 92 | $10K | $209 | $94 | 2.2x | 3.7x (90th percentile 6.9x) |
| 52000 | Diagnostic exam of bladder and urethra using an endoscope | 61 | 48 | $7K | $307 | $152 | 2.0x | 3.3x (90th percentile 9.1x) |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | 37 | 37 | $4K | $310 | $153 | 2.0x | 2.4x (90th percentile 3.9x) |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | 24 | 24 | $951 | $81 | $40 | 2.0x | 2.3x (90th percentile 3.8x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
25 providers in Shelby County, TN carry an indicator in the public record, with $12.2M at stake between them. The most common is more hours than a day holds, on 12 of them, followed by named in an enforcement record on 7. 6 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | POPLAR AVENUE CLINIC PLLC Memphis, TN, ranked 54 | $1.5M |
|
| 1 | OTYLIA PRIMARY CARE, LLC Memphis, TN, ranked 207 | $37K |
|
| 1 | WHAT ABOUT US IN HOME HEALTH CARE Memphis, TN, ranked 484 | $0 |
|
| 1 | ADVANCED FOOT & ANKLE CARE OF MEMPHIS, LLC Memphis, TN, ranked 498 | $0 |
|
| 1 | NAKITA CANNADY Bartlett, TN, ranked 568 | $0 |
|
| 1 | NATHAN LUCAS Memphis, TN, ranked 626 | $0 |
|
| 2 | NARICIA FUTRELL Millington, TN, ranked 715 | $893K |
|
| 3 | RANDE LAZAR Memphis, TN, ranked 1316 | $141K |
|
Recent enforcement in TN
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJCivil settlementAug 10, 2026
Celina Pharmacy Owner/Two Pharmacies Agree to Pay $450,000 & Receive Ban on Handling Controlled Substances
The defendants knowingly dispensed controlled substances without valid prescriptions and outside the usual course of professional pharmacy practice, and falsely billed Medicare for prescriptions that were not medically necessary or otherwise eligible for reimbursement.
DOJSentencedJul 8, 2026
Memphis Gynecologist Sentenced to 20 Years in Prison for Adulterating Medical Devices and Health Care Fraud
Kumar used adulterated and unlabeled single-use and improperly reprocessed reusable hysteroscopy devices in more than 15,000 hysteroscopy with biopsy procedures and billed Medicare and Medicaid for the procedures.
DOJSentencedJun 24, 2026
Celina Pharmacy Owner Sentenced for Opioid Distribution/Health Care Fraud
The majority owner of two pharmacies conspired to unlawfully dispense controlled substances despite red flags of abuse and diversion, submitted false claims to Medicare Part D and TennCare, and paid patient co-payments, cash, and "Monkey Bucks" to increase prescription volume.
DOJChargedJun 23, 2026
Clarksville Physician Charged with Health Care Fraud Related to Controlled Substance Prescribing Scheme
Aquino owned and operated North Clarksville Medical Center and for more than five years prescribed medically unnecessary controlled substances, totaling more than 1.08 million pills and doses, that were not issued for a legitimate medical purpose in the usual course of professional practice, causing losses of approximately $335,621.73 to health care benefit programs.
DOJIndictedJun 23, 2026
Gordonsville Physician Indicted on Health Care Fraud and Controlled Substance Charges
Moss owned and operated Gordonsville Clinic and prescribed medically unnecessary controlled substances, totaling more than 5.6 million pills and doses over more than eight years, that were not issued for a legitimate medical purpose in the usual course of professional practice.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.