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SWARUP SHARMA RIJAL MD
NPI 1043822190
Internal Medicine in West Reading, PA

Active since August 20, 2020PECOS EnrolledAccepts Medicare Assignment
81.19/100
CMS Quality Rating
420 S 5TH AVE, WEST READING, PA 19611(484) 628-8640 Get Directions Write a Review

NPPES record last updated: May 3, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 3, 2023, Aug 20, 2020 (2 updates tracked since 2020).

About Swarup Sharma Rijal Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SWARUP SHARMA RIJAL MD (NPI 1043822190) is an individual internal medicine provider in West Reading, Pennsylvania, licensed in Pennsylvania (MT219748) and active in the NPI registry since August 2020. He is enrolled in Medicare PECOS, is affiliated with Reading Hospital, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1043822190
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameSWARUP SHARMA RIJALCredential: MD
Location Address420 S 5TH AVEWest Reading, PA 19611-2143
Mailing AddressPo Box 13579Reading, PA 19612-3579
Phone(484) 628-8640
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateAugust 20, 2020
Last NPPES UpdateMay 3, 20232 updates tracked since enumeration
NPPES CertifiedFebruary 3, 2022
✔ NPI 1043822190 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in PA · MT219748
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
420 S 5TH AVE, West Reading, PA 19611
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Swarup Sharma Rijal Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8123446648
PECOS Enrollment IDI20230707002862
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
446 services192 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
101 services100 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
67 services65 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
43 services34 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Reading Hospital

Acute Care Hospitals · West Reading, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390044
Location420 S 5th AvenueWest Reading, PA 19611 · Berks County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19611 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.19/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality74.56
Promoting Interoperability97
Improvement Activities40
Cost65.23

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TOLUWANIMI OGBONMIDE
Student in an Organized Health Care Education/Training Program
420 S 5TH AVE
WEST READING, PA 19611
Berks County (484) 628-8000
URVASHI SARKAR
Student in an Organized Health Care Education/Training Program
420 S 5TH AVE
WEST READING, PA 19611
Berks County (484) 628-8000
MADISON HECK
Student in an Organized Health Care Education/Training Program
420 S 5TH AVE
WEST READING, PA 19611
Berks County (484) 628-8000
NEIL HOFFMAN M.D.
Pathology (Forensic Pathology)
420 S 5TH AVE
WEST READING, PA 19611
Berks County (484) 628-8615
MS. LANE ROSCOE PA- C
Physician Assistant
420 S 5TH AVE
WEST READING, PA 19611
Berks County (610) 568-3637
ALICE LEE DO
Surgery
420 S 5TH AVE
WEST READING, PA 19611
Berks County (484) 628-4879
KYLE ROMPALA
Nurse Practitioner (Family)
420 S 5TH AVE
READING, PA 19611
Berks County (267) 280-7615
MATTHEW CRYER
Student in an Organized Health Care Education/Training Program
420 S 5TH AVE
WEST READING, PA 19611
Berks County (484) 628-1324

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Swarup Sharma Rijal's NPI number?

The NPI number for Swarup Sharma Rijal is 1043822190. It was assigned to this individual provider in the NPPES registry on August 20, 2020.

Where is Swarup Sharma Rijal located?

Swarup Sharma Rijal practices at 420 S 5th Ave, West Reading, PA 19611. The listed phone number is (484) 628-8640.

What is Swarup Sharma Rijal's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Swarup Sharma Rijal enrolled in Medicare?

Yes. Swarup Sharma Rijal is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Swarup Sharma Rijal affiliated with any hospitals?

According to CMS data, Swarup Sharma Rijal is affiliated with Reading Hospital.

When was this NPI record last updated?

The NPPES record for Swarup Sharma Rijal was last updated on May 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.