ROSHAN GHIMIRE MD
NPI 1184936072
Family Medicine in Fayetteville, NY

Q: What is Roshan Ghimire's NPI number?

The NPI number for Roshan Ghimire is 1184936072. It was assigned to this individual provider in the NPPES registry on July 8, 2010.

Q: What is Roshan Ghimire's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Roshan Ghimire was last updated on June 20, 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.

Active since July 08, 2010PECOS EnrolledAccepts Medicare Assignment

4000 MEDICAL CENTER DR, SUITE 104, FAYETTEVILLE, NY 13066(315) 637-7878 Get Directions Write a Review

NPPES record last updated: June 20, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 20, 2023, Jun 1, 2023, Jun 8, 2020 (3 updates tracked since 2020).

On this page

About Roshan Ghimire Md NPPES

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

ROSHAN GHIMIRE MD (NPI 1184936072) is an individual family medicine provider in Fayetteville, New York, licensed in New York (317104) and active in the NPI registry since July 2010. He is enrolled in Medicare PECOS, is affiliated with St Joseph's Hospital Health Center, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1184936072

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameROSHAN GHIMIRECredential: MD

Location Address4000 MEDICAL CENTER DR, SUITE 104Fayetteville, NY 13066

Mailing Address4000 Medical Center Dr, Suite 104Fayetteville, NY 13066 · (315) 637-7878

Phone(315) 637-7878

Sole ProprietorNo

Medical School CMSOtherGraduated 2007

Enumeration DateJuly 8, 2010

Last NPPES UpdateJune 20, 20233 updates tracked since enumeration

NPPES CertifiedJune 7, 2023

✔ NPI 1184936072 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NY · 317104

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

4000 MEDICAL CENTER DR, Fayetteville, NY 13066

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota.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

Roshan Ghimire 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 ID9335391135

PECOS Enrollment IDI20220806000037

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 Roshan Ghimire reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Syracuse Community Health Center

6.4 mi

Federally Qualified Health Center (FQHC)

930 S SALINA ST
Syracuse, NY 13202

Reassigned Medicare billing, New York enrollment
87 clinicians in this Medicare group

NPI 1184886988 (315) 476-7921

St Josephs Hospital Health Center

6.5 mi

General Acute Care Hospital

301 PROSPECT AVE, ADMINISTRATION
Syracuse, NY 13203

Reassigned Medicare billing, New York enrollment
369 clinicians in this Medicare group

NPI 1508815333 (315) 448-5880

St Josephs Medical PC

8.9 mi

Family Medicine

5100 W TAFT RD
Liverpool, NY 13088

Reassigned Medicare billing, New York enrollment
625 clinicians in this Medicare group

NPI 1942501747 (315) 452-2828

Altru Health System

1,010 mi

Rural Health

412 MAIN AVE NE
Warroad, MN 56763

Reassigned Medicare billing, Minnesota enrollment
193 clinicians in this Medicare group

NPI 1689763195 (218) 386-2020

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 18

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

119 services74 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

110 services78 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

86 services73 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

80 services49 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

76 services76 patients

Blood test, thyroid stimulating hormone (tsh) 84443

A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.

73 services64 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

70 services49 patients

Blood test, comprehensive group of blood chemicals 80053

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

66 services63 patients

Blood test, lipids (cholesterol and triglycerides) 80061

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

60 services58 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

54 services42 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.

54 services19 patients

Blood test, basic group of blood chemicals (calcium, total) 80048

A basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.

42 services35 patients

Vitamin d-3 level 82306

A Vitamin D-3 level test measures the amount of Vitamin D-3, a crucial nutrient, in your body. This test helps identify if your levels are too low or too high. Low levels may lead to bone weakness, while high levels could harm your kidneys. It's a simple blood test.

23 services22 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.

14 services13 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.

14 services13 patients

Prostate cancer screening; prostate specific antigen test (psa) G0103

Prostate cancer screening involves a simple blood test known as the Prostate Specific Antigen (PSA) test. This test measures the level of PSA in your blood. Higher than normal levels can be an early indication of prostate issues, including cancer. It's a key tool in early detection.

13 services13 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

12 services12 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.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

St Joseph's Hospital Health Center

Acute Care Hospitals · Syracuse, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330140

Location301 Prospect AvenueSyracuse, NY 13203 · Onondaga County

Emergency services Birthing friendly

Crouse Hospital

Acute Care Hospitals · Syracuse, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330203

Location736 Irving AvenueSyracuse, NY 13210 · Onondaga County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13066 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

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

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.

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 suppliers13 claims13 services$16.18 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

3 suppliers26 claims26 services$75.53 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.

RUI WANG

Acupuncturist

4000 MEDICAL CENTER DR, SUITE 209
FAYETTEVILLE, NY 13066

Onondaga County (315) 329-7666

UNITY MOVE PHYSICAL THERAPY WELLNESS PLLC

Clinic/Center (Physical Therapy)

4000 MEDICAL CENTER DR, STE 108
FAYETTEVILLE, NY 13066

Onondaga County (315) 961-6007

TARA BRACKLEY OD

Optometrist

4000 MEDICAL CENTER DR, SUITE 207
FAYETTEVILLE, NY 13066

Onondaga County (315) 637-1010

GERARD S RODZIEWICZ MD

Neurological Surgery

4000 MEDICAL CENTER DR, SUITE 108
FAYETTEVILLE, NY 13066

Onondaga County (315) 637-7900

DEVYN LEIGH HARDY FNP-C

Nurse Practitioner (Family)

4000 MEDICAL CENTER DR, UNIT 110
FAYETTEVILLE, NY 13066

Onondaga County (315) 663-0100

DENISE C. WOLKEN, MD PLLC

Pediatrics

4000 MEDICAL CENTER DR, SUITE 214
FAYETTEVILLE, NY 13066

Onondaga County (315) 991-4180

LAUREN KRISAK GILKEY RPA-C

Physician Assistant

4000 MEDICAL CENTER DR, SUITE 101 D
FAYETTEVILLE, NY 13066

Onondaga County (315) 637-7878

DR. BETH THOMAS WIEDEMAN MD.

Family Medicine

4000 MEDICAL CENTER DR, SUITE 104
FAYETTEVILLE, NY 13066

Onondaga County (315) 663-0059

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 Roshan Ghimire's NPI number?

The NPI number for Roshan Ghimire is 1184936072. It was assigned to this individual provider in the NPPES registry on July 8, 2010.

Where is Roshan Ghimire located?

Roshan Ghimire practices at 4000 Medical Center Dr Suite 104, Fayetteville, NY 13066. The listed phone number is (315) 637-7878.

What is Roshan Ghimire's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Roshan Ghimire enrolled in Medicare?

Yes. Roshan Ghimire 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.

Which organizations bill Medicare for Roshan Ghimire's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Roshan Ghimire reassigns Medicare benefits to 4 organizations: Syracuse Community Health Center (Syracuse, NY), St Josephs Hospital Health Center (Syracuse, NY), St Josephs Medical PC (Liverpool, NY) and Altru Health System (Warroad, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Roshan Ghimire's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Roshan Ghimire accept?

Health plans from Blue Cross Blue Shield of North Dakota list Roshan Ghimire 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 Roshan Ghimire affiliated with any hospitals?

According to CMS data, Roshan Ghimire is affiliated with St Joseph's Hospital Health Center and Crouse Hospital.

When was this NPI record last updated?

The NPPES record for Roshan Ghimire was last updated on June 20, 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.