DR. ABHISH KOIRALA M.D.
NPI 1134474471
Hospitalist in Herrin, IL

Q: What is Abhish Koirala's NPI number?

The NPI number for Abhish Koirala is 1134474471. It was assigned to this individual provider in the NPPES registry on July 23, 2012.

Q: What is Abhish Koirala's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Q: When was this NPI record last updated?

The NPPES record for Abhish Koirala was last updated on June 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since July 23, 2012PECOS EnrolledAccepts Medicare Assignment

76.78/100

CMS Quality Rating

201 S 14TH ST, HERRIN, IL 62948(618) 942-2171(618) 988-6166 Get Directions Write a Review

NPPES record last updated: June 4, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 4, 2021, Dec 3, 2020, Mar 6, 2019 and 1 more (4 updates tracked since 2017).

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About Dr. Abhish Koirala M.d. NPPES

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

DR. ABHISH KOIRALA M.D. (NPI 1134474471) is an individual hospitalist provider in Herrin, Illinois, licensed in Illinois (036141729) and active in the NPI registry since July 2012. He is enrolled in Medicare PECOS, is affiliated with Tristar Skyline Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1134474471

Entity TypeIndividualMale

Primary Taxonomy208M00000X

Provider Legal NameDR. ABHISH KOIRALACredential: M.D.

Location Address201 S 14TH STHerrin, IL 62948-3631

Mailing AddressPo Box 3988Carbondale, IL 62902-3988 · (618) 942-2171 · Fax (618) 988-6166

Phone(618) 942-2171

Fax(618) 988-6166

Sole ProprietorYes

Medical School CMSOtherGraduated 2010

Enumeration DateJuly 23, 2012

Last NPPES UpdateJune 4, 20214 updates tracked since enumeration

NPPES CertifiedJune 4, 2021

✔ NPI 1134474471 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

License✔ Licensed in IL · 036141729

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Also ListedInternal MedicineTaxonomy 207R00000X · License 252423 (MA)

201 S 14TH ST, Herrin, IL 62948

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Secondary Practice Locations 2

Location 12 S Hospital DrMurphysboro, IL 62966-3333 · Phone (618) 684-3156 · Fax (618) 684-1040

Location 2405 W Jackson StCarbondale, IL 62901-1462 · Phone (618) 549-0721 · Fax (618) 529-0479

Other Identifiers 1

Other214881IL · Group Ptan Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Abhish Koirala 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 ID6507186913

PECOS Enrollment IDI20230609000405

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.

Medicare Billing Reassignments

Medicare enrollment records show Abhish Koirala reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Southern Illinois Medical Services, Nfp

10 mi

Internal Medicine

1239 E MAIN ST
Carbondale, IL 62901

Reassigned Medicare billing, Illinois enrollment
702 clinicians in this Medicare group

NPI 1770656837 (618) 457-5200

Emergency Medicine Services Of Tn, PC

167 mi

Emergency Medicine

2300 PATTERSON ST
Nashville, TN 37203

Reassigned Medicare billing, Tennessee enrollment
414 clinicians in this Medicare group

NPI 1720785884 (615) 342-1000

Hospital Medicine Services Of Tn, LLC

167 mi

Hospitalist

2300 PATTERSON ST
Nashville, TN 37203

Reassigned Medicare billing, Tennessee enrollment
420 clinicians in this Medicare group

NPI 1982301065 (615) 342-1001

Family Health Group Inc

186 mi

Anesthesiology

854 W JAMES CAMPBELL BLVD
Columbia, TN 38401

Reassigned Medicare billing, Tennessee enrollment
Medicare enrollment name: Maury Regional Medical Group, Inc
228 clinicians in this Medicare group

NPI 1134553878 (931) 540-4255

24 On Physicians, PC

246 mi

Hospitalist

1100 E NORRIS DR
Ottawa, IL 61350

Reassigned Medicare billing, Illinois enrollment
233 clinicians in this Medicare group

NPI 1346480431 (800) 923-2247

Southeastern Physician Services PC

292 mi

Hospitalist

990 OAK RIDGE TPKE
Oak Ridge, TN 37830

Reassigned Medicare billing, Tennessee enrollment
1,085 clinicians in this Medicare group

NPI 1083835441 (865) 481-1000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 7

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 straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

348 services145 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.

179 services72 patients

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.

168 services89 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

151 services151 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

21 services21 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.

19 services19 patients

Hospital Affiliations CMS Care Compare

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

Tristar Skyline Medical Center

Acute Care Hospitals · Nashville, TN

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440006

Location3441 Dickerson PikeNashville, TN 37207 · Davidson County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62948 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

$127.46 typical visit price

range $54.80 – $168.44

Typical copayment $31.86 (range $13.70 – $42.11)

Most-billed visit code 99204

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

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.

76.78/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

68.24

Promoting Interoperability

100

Improvement Activities

Cost

54.37

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

2 suppliers21 claims21 services$18.37 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

5 suppliers46 claims46 services$107.75 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

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