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PRADEEP DAHAL M.D.
NPI 1134431059
Internal Medicine in Baltimore, MD

Active since July 08, 2010PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
5601 LOCH RAVEN BLVD, RMB, STE. 502, BALTIMORE, MD 21239(443) 444-4863(443) 444-4997 Get Directions Write a Review

NPPES record last updated: February 20, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Pradeep Dahal M.d. NPPES

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

PRADEEP DAHAL M.D. (NPI 1134431059) is an individual internal medicine provider in Baltimore, Maryland, licensed in Maryland (P25311) and active in the NPI registry since July 2010. He is enrolled in Medicare PECOS, is affiliated with Unc Health Wayne, and maintains a secondary practice location in Goldsboro.

NPPES Registry Identity

NPI1134431059
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NamePRADEEP DAHALCredential: M.D.
Location Address5601 LOCH RAVEN BLVD, RMB, STE. 502Baltimore, MD 21239-2905
Mailing Address5601 Loch Raven Blvd, Rmb, Ste. 502Baltimore, MD 21239-2905 · (443) 444-4863 · Fax (443) 444-4997
Phone(443) 444-4863
Fax(443) 444-4997
Sole ProprietorYes
Medical School CMSOtherGraduated 2006
Enumeration DateJuly 8, 2010
Last NPPES UpdateFebruary 20, 2025
NPPES CertifiedFebruary 20, 2025
✔ NPI 1134431059 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MD · P25311
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.
5601 LOCH RAVEN BLVD, Baltimore, MD 21239
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Secondary Practice Location 1

Location 12700 Wayne Memorial DrGoldsboro, NC 27534-9494 · Phone (919) 587-4394

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sanford Health Plan.Insurance ›

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

Pradeep Dahal M.d. 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 ID6305086919
PECOS Enrollment IDI20230911001363
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 5

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.
354 services139 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.
289 services103 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.
108 services105 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
26 services25 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.
22 services22 patients

Hospital Affiliations CMS Care Compare

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

Unc Health Wayne

Acute Care Hospitals · Goldsboro, NC
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340010
Location2700 Wayne Memorial DrGoldsboro, NC 27534 · Wayne County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21239 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
$139.05 typical visit price
range $60.73 – $183.44
Typical copayment $34.76 (range $15.18 – $45.86)
Most-billed visit code 99204
Established Patient
$106.59 typical visit price
range $19.60 – $149.17
Typical copayment $26.64 (range $4.90 – $37.29)
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality94.09
Promoting Interoperability100
Improvement Activities40
Cost84.72

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.

JACQUELINE L. HOOVER P.A.-C
Physician Assistant
5601 LOCH RAVEN BLVD, BALTIMORE
BALTIMORE, MD 21239
Baltimore City (443) 444-4730
DR. TIFFANI DANIELLE PITTMAN M.D.
Anesthesiology
5601 LOCH RAVEN BLVD
BALTIMORE, MD 21239
Baltimore City (443) 444-4863
DR. SUJAN THAPALIYA M.D.
Internal Medicine
5601 LOCH RAVEN BLVD
BALTIMORE, MD 21239
Baltimore City (855) 633-0363
SHARAREH SHERRY BADRI M.D.
Internal Medicine (Geriatric Medicine)
5601 LOCH RAVEN BLVD
BALTIMORE, MD 21239
Baltimore City (443) 444-6100
ALAYNA MARIE BLAZAKIS CRNP
Nurse Practitioner
5601 LOCH RAVEN BLVD
BALTIMORE, MD 21239
Baltimore City (443) 444-4275
DR. ELIAS K SHAYA M.D.
Psychiatry & Neurology (Psychiatry)
5601 LOCH RAVEN BLVD, RMB 406
BALTIMORE, MD 21239
Baltimore City (410) 532-4540
CANDICE DIOR JORDAN M.D.
Emergency Medicine
5601 LOCH RAVEN BLVD
BALTIMORE, MD 21239
Baltimore City (855) 633-5655
SONJA STANTON RN BSN
Registered Nurse (Gerontology)
5601 LOCH RAVEN BLVD
BALTIMORE, MD 21239
Baltimore City (443) 444-6100

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 Pradeep Dahal's NPI number?

The NPI number for Pradeep Dahal is 1134431059. It was assigned to this individual provider in the NPPES registry on July 8, 2010.

Where is Pradeep Dahal located?

Pradeep Dahal practices at 5601 Loch Raven Blvd Rmb, Ste. 502, Baltimore, MD 21239. The listed phone number is (443) 444-4863.

What is Pradeep Dahal's specialty?

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

Is Pradeep Dahal enrolled in Medicare?

Yes. Pradeep Dahal 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.

What insurance does Pradeep Dahal accept?

Health plans from Sanford Health Plan list Pradeep Dahal as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Pradeep Dahal affiliated with any hospitals?

According to CMS data, Pradeep Dahal is affiliated with Unc Health Wayne.

When was this NPI record last updated?

The NPPES record for Pradeep Dahal was last updated on February 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.