Arathi Kumar, MD
General Surgery · San Jose
- Medicare standing
- Clear
- Enrolled, allowed to bill and order, not excluded
- Plans that list them
- 20
- 4 carriers
- Office
- 1
- Since medical school
- 12 years
- Graduated 2014
Offices
1 location · County of Santa Clara · 1,000 clinicians in this group
Hospitals listed: Santa Clara Valley Medical Center. That is not proof they admit you there this week.
Plans that list them
20 plans · 4 carriers
A missing listing does not mean out of network. Directories change, and a listing does not cover every office. Call Dr. Kumar’s office at (408) 885-5000 to confirm they take your plan. Ask about the office you use, its medical group, referrals and appointments.
20 of 20 plans
| Alignment Health BreathEasy (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Clarity (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Harmony (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Heart & Diabetes (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Heart & Diabetes CalPlus (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Heart & Diabetes Care (HMO C-SNP) | Alignment Health Plan | Listed | Sep 28, 2026 |
| Alignment Health Heart & Diabetes Choice (HMO C-SNP) | Alignment Health Plan | Listed | Sep 28, 2026 |
| Alignment Health Honor+ Plan (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health My Choice CalCare (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health Silicon (HMO C-SNP) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health smartHMO (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Alignment Health the ONE (HMO) | Alignment Health Plan | Listed | Oct 3, 2026 |
| Anthem Full Dual Advantage Aligned (HMO D-SNP) | Anthem Blue Cross | Listed | Oct 3, 2026 |
| Anthem Medicare Advantage (HMO-POS) | Anthem Blue Cross | Listed | Oct 3, 2026 |
| Central Health Classic Care Plan III (HMO) | Central Health Medicare Plan | Listed | Aug 15, 2026 |
| Central Health Dual Access Plan (HMO D-SNP) | Central Health Medicare Plan | Listed | Aug 15, 2026 |
| Central Health Embrace Care Plan (HMO C-SNP) | Central Health Medicare Plan | Listed, may be out of date | Sep 15, 2025 |
| Central Health Embrace Choice Plan (HMO C-SNP) | Central Health Medicare Plan | Listed | Aug 15, 2026 |
| Central Health Valor Care Plan (HMO) | Central Health Medicare Plan | Listed | Aug 15, 2026 |
| DualConnect (HMO D-SNP) | Santa Clara Family Health Plan | Listed | Sep 1, 2026 |
California Medical Board record
Licence A169610 · Current
Licensed to practise in California · since 2020 · expires 2028-08-31 · Ross University School of Medicine.
No disciplinary actions, convictions, malpractice judgments or citations in this record.
Hospitals they work in
1 hospital
These rate the hospital, not this clinician. Most measures at most hospitals are no different from the national rate.
- Santa Clara Valley Medical CenterSan Jose, CAAcute Care Hospital · Government - Local · Has an emergency department · Birthing-friendlyPart of Santa Clara Valley Health and Hospital System, which runs 3 hospitalsPatients rate it 3 of 5 · 70% would definitely recommend itOverall rating: 2 of 5 starsWorse than the national rate — SSI - Colon Surgery: 2.572, Oct 2024 – Sep 2025Better than the national rate — Central Line Associated Bloodstream Infection (ICU + select Wards): 0.563, Oct 2024 – Sep 2025Better than the national rate — Clostridium Difficile (C.Diff): 0.256, Oct 2024 – Sep 2025Better than the national rate — MRSA Bacteremia: 0.369, Oct 2024 – Sep 2025
See every measure and the patient survey for Santa Clara Valley Medical Center
Behind the star rating — Deaths: 2 better, 6 the same, 0 worse of 8 measures. Safety: 2 better, 5 the same, 1 worse of 8 measures. Readmissions: 0 better, 10 the same, 1 worse of 11 measures. The star rating is worked out from an earlier period than the measures below, so the two can disagree.
| SSI - Colon SurgeryInfections | 2.572 | Worse | Oct 2024 – Sep 2025 |
| Central Line Associated Bloodstream Infection (ICU + select Wards)Infections | 0.563 | Better | Oct 2024 – Sep 2025 |
| Clostridium Difficile (C.Diff)Infections | 0.256 | Better | Oct 2024 – Sep 2025 |
| MRSA BacteremiaInfections | 0.369 | Better | Oct 2024 – Sep 2025 |
| Abdominopelvic accidental puncture or laceration rateComplications and deaths | 1.25 (0.3 to 2.2) · 1,535 cases | No different | Jul 2022 – Jun 2024 |
| CMS Medicare PSI 90: Patient safety and adverse events compositeComplications and deaths | 1.07 (0.76 to 1.38) | No different | Jul 2022 – Jun 2024 |
| Death rate among surgical inpatients with serious treatable complicationsComplications and deaths | 214.59 (167.38 to 261.8) · 108 cases | No different | Jul 2022 – Jun 2024 |
| Death rate for CABG surgery patientsComplications and deaths | 2.8 · 41 cases | None | Jul 2022 – Jun 2025 |
| Death rate for COPD patientsComplications and deaths | 6 · 141 cases | None | Jul 2022 – Jun 2025 |
| Death rate for heart attack patientsComplications and deaths | 10.2 · 124 cases | None | Jul 2022 – Jun 2025 |
| Death rate for heart failure patientsComplications and deaths | 8.3 · 501 cases | None | Jul 2022 – Jun 2025 |
| Death rate for pneumonia patientsComplications and deaths | 14.9 · 653 cases | None | Jul 2022 – Jun 2025 |
| Death rate for stroke patientsComplications and deaths | 10.1 · 348 cases | None | Jul 2023 – Jun 2025 |
| Hybrid Hospital-Wide All-Cause Risk Standardized Mortality RateComplications and deaths | 3 · 4,502 cases | None | Jul 2024 – Jun 2025 |
| Iatrogenic pneumothorax rateComplications and deaths | 0.24 (0.04 to 0.43) · 9,014 cases | No different | Jul 2022 – Jun 2024 |
| In-hospital fall-associated fracture rateComplications and deaths | 0.34 (0.15 to 0.52) · 9,216 cases | No different | Jul 2022 – Jun 2024 |
| Perioperative pulmonary embolism or deep vein thrombosis rateComplications and deaths | 4.54 (2.51 to 6.58) · 1,421 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative acute kidney injury requiring dialysis rateComplications and deaths | 1.54 (0 to 3.2) · 288 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative hemorrhage or hematoma rateComplications and deaths | 2.11 (0.66 to 3.56) · 1,446 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative respiratory failure rateComplications and deaths | 11.61 (4.09 to 19.14) · 294 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative sepsis rateComplications and deaths | 7.29 (3.39 to 11.2) · 299 cases | No different | Jul 2022 – Jun 2024 |
| Postoperative wound dehiscence rateComplications and deaths | 1.9 (0.45 to 3.36) · 333 cases | No different | Jul 2022 – Jun 2024 |
| Pressure ulcer rateComplications and deaths | 0.23 (0 to 0.78) · 7,538 cases | No different | Jul 2022 – Jun 2024 |
| Rate of complications for hip/knee replacement patientsComplications and deaths | 5.4 · 94 cases | None | Apr 2023 – Mar 2025 |
| Catheter Associated Urinary Tract Infections (ICU + select Wards)Infections | 0.735 | No different | Oct 2024 – Sep 2025 |
| SSI - Abdominal HysterectomyInfections | 2.573 | No different | Oct 2024 – Sep 2025 |
| Acute Myocardial Infarction (AMI) 30-Day Readmission RateUnplanned return visits | 14.6 · 185 cases | None | Jul 2023 – Jun 2025 |
| Heart failure (HF) 30-Day Readmission RateUnplanned return visits | 22.1 · 951 cases | None | Jul 2023 – Jun 2025 |
| Hospital return days for heart attack patientsUnplanned return visits | 56.3 · 128 cases | None | Jul 2022 – Jun 2025 |
| Hospital return days for heart failure patientsUnplanned return visits | 6.4 · 644 cases | None | Jul 2022 – Jun 2025 |
| Hospital return days for pneumonia patientsUnplanned return visits | 1.3 · 699 cases | None | Jul 2022 – Jun 2025 |
| Pneumonia (PN) 30-Day Readmission RateUnplanned return visits | 16.3 · 921 cases | None | Jul 2023 – Jun 2025 |
| Rate of emergency department (ED) visits for patients receiving outpatient chemotherapyUnplanned return visits | 5.7 (3.9 to 8.1) · 226 cases | No different | Jan 2024 – Dec 2024 |
| Rate of inpatient admissions for patients receiving outpatient chemotherapyUnplanned return visits | 12.6 (9.4 to 16.5) · 226 cases | No different | Jan 2024 – Dec 2024 |
| Rate of readmission after hip/knee replacementUnplanned return visits | 5.4 · 94 cases | None | Jul 2023 – Jun 2025 |
| Rate of readmission for CABGUnplanned return visits | 11.4 · 54 cases | None | Jul 2023 – Jun 2025 |
| Rate of readmission for chronic obstructive pulmonary disease (COPD) patientsUnplanned return visits | 20.3 · 242 cases | None | Jul 2023 – Jun 2025 |
| Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)Unplanned return visits | 13.2 (9.9 to 17.4) · 702 cases | No different | Jan 2022 – Dec 2024 |
| Ratio of unplanned hospital visits after hospital outpatient surgeryUnplanned return visits | 1 (0.7 to 1.4) · 195 cases | No different | Jan 2024 – Dec 2024 |
What patients said (4,032 patients answered, 29% of those asked)
| Cleanliness | 3 |
| Nurse communication | 3 |
| Doctor communication | 3 |
| Communication about medicines | 3 |
| Discharge information | 2 |
| Overall hospital rating | 3 |
| Quietness | 2 |
| Recommend hospital | 4 |
| Room was "always" clean | 70% |
| Nurses "always" communicated well | 73% |
| Doctors "always" communicated well | 76% |
| Staff "always" explained | 57% |
| Yes, staff "did" give patients this information | 82% |
| Yes, staff "did" give patients information about help after discharge | 82% |
| Doctors "always" explained things so they could understand | 71% |
| Doctors "always" listened carefully | 74% |
| Doctors "always" treated them with courtesy and respect | 82% |
| Patients who gave a rating of "9" or "10" (high) | 67% |
| Staff "always" explained new medications | 71% |
| Nurses "always" explained things so they could understand | 71% |
| Nurses "always" listened carefully | 69% |
| Nurses "always" treated them with courtesy and respect | 80% |
| "Always" quiet at night | 43% |
| "YES", patients would definitely recommend the hospital | 70% |
| Staff "always" explained possible side effects | 44% |
| Yes, staff "did" give patients information about possible symptoms | 83% |
Original Medicare doctor bills
$35,562
Medicare paid this office $35,562 for 144 people.
This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.
| Critical care, first 30-74 minutes | 22 | $10,749 | $185 |
| Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes | 58 | $4,820 | $43 |
| Initial hospital care with straightforward or low level of medical decision making, per day at least 40 minutes | 43 | $3,246 | $69 |
| Hospital discharge day management, 30 minutes or less | 25 | $1,852 | $74 |
Who their Medicare patients are
144 Original Medicare patients in 2024. Average age 76 · Under 65 12% · 85 and older 26% · Women 55% · Also on Medicaid 63% · Health risk score 2.18. Above the middle of the specialty; the typical general surgery clinician is at 1.69.
Conditions among them: High blood pressure 75% · Diabetes 48% · Depression 35% · Chronic kidney disease 34% · Atrial fibrillation 33% · Heart failure 32% · Stroke 32% · Coronary heart disease 31% · Dementia 29% · COPD 21% · Cancer 13%.
The office billed $408,490, Medicare allowed $45,241 and paid $35,562; for 312 services of 37 kinds.
Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.
Year by year
| 2024 | 144 | 312 | 76 | 2.18 | $408,490 | $35,562 |
| 2023 | 62 | 129 | 73 | 1.66 | $236,988 | $21,360 |
| 2022 | 69 | 137 | 74 | 1.93 | $203,490 | $19,771 |
Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.
See the services billed each year
2023: 1 service
| Critical care, first 30-74 minutes | 24 | $13,880 | $193 |
2022: 3 services
| Critical care, first 30-74 minutes | 14 | $8,116 | $225 |
| Subsequent hospital care with moderate levelof medical decision making at least 35 minutes | 25 | $3,505 | $78 |
| Initial hospital care with straightforward or low-level medical decision making at least 55 minutes | 22 | $3,238 | $147 |
Medicaid work
$7,816 in 2024
Medicaid paid $7,816 for 382 billed services this clinician did in 2024, up to 28 people in a month for one service.
Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.
| Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes | 39 | $3,952 |
| SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES | 236 | $2,869 |
| 1ST HOSP IP/OBS SF/LOW 40 | 66 | $766 |
| Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter | 15 | $229 |
| Medication list documented in medical record (COA) | 26 | $0 |
| 2024 | 382 | 5 | 28 | $7,816 |
| 2023 | 35 | 1 | 14 | $1,875 |
| 2022 | 112 | 2 | 24 | $2,267 |
See the largest Medicaid services in earlier years
2023
| Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes | 35 | $1,875 |
2022
| SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES | 94 | $1,877 |
| 1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES | 18 | $390 |
Drugs they prescribed that Part D paid
$118
Pharmacies billed $118 in 2024.
This is pharmacy cost, not the office bill, and not what patients paid.
33 generic and 0 brand-name prescriptions · $118 in drug cost.
Part D prescriptions only. The opioid rate is opioid prescriptions as a share of all this clinician's Part D prescriptions; surgeons and pain specialists run higher than others, so it is shown against the same specialty.
Year by year
| 2024 | 33 | 14 | None | 0% | $118 |
| 2023 | 27 | 14 | None | None | $730 |
| 2022 | 18 | 15 | None | None | $213 |
| 2019 | 11 | None | 0% (0) | None | $211 |
| 2016 | 20 | 13 | None | None | $705 |
| 2015 | 50 | 26 | None | 26% | $6,222 |
| 2014 | 27 | 11 | 0% (0) | None | $1,259 |
Part D prescriptions only. A drug prescribed to fewer than 11 people in a year is hidden.
Money from drug and device companies
$3 in 2025
| 2025 | 1 | 1 | None | $3 |
| 2024 | 1 | 4 | None | $4,044 |
| 2023 | 1 | 5 | None | $175 |
| 2021 | 1 | 1 | None | $18 |
Paid work is consulting, speaking, honoraria and royalties, as opposed to meals and travel.
A payment is not proof that care is biased.
| Intuitive Surgical | Da Vinci Surgical System | $3 | 1 payment
|
See the published payment
| Intuitive Surgical | Meals · 2025-01-21 | Da Vinci Surgical System | $3 |
See earlier years (2024, 2023, 2021)
2024: $4,044
| Intuitive Surgical | Davinci Xi | $4,044 | 4 payments
|
2023: $175
| KLS-Martin L.P. | None | $175 | 5 payments
|
2021: $18
| Janssen Pharmaceuticals | Xarelto | $18 | 1 payment
|
Checkups this office reported
Medicare did not publish checkup rates for this clinician.
- Medicare’s overall office score
- 80.6 / 100
- Scores the office’s reporting and systems. It is not a grade for how the doctor treats you.
Professional record
- NPI
- 1205241445
- Licence
- CA A169610California A169610: Current · expires 2028-08-31
- Gender
- Female
More record details
- Sole proprietor
- No
- Taxonomy
- Surgery (208600000X); Federal specialty code 2086S0102X (2086S0102X)
- Mailing address
- 751 S Bascom Ave Rm 4q151, San Jose, CA, 95128
- NPI first listed
- 2014-06-26
- NPI last updated
- 2022-01-11
- NPI record certified
- 2022-01-09
This is when the NPI record was last certified, not a medical board exam.