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DR. KUBER PRASAD GHIMIRE M.D.
NPI 1205115359
Internal Medicine in High Point, NC

Active since August 08, 2011PECOS EnrolledAccepts Medicare Assignment
601 N ELM ST, HIGH POINT, NC 27262(336) 716-2255 Get Directions Write a Review

NPPES record last updated: September 10, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Kuber Prasad Ghimire M.d. NPPES

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

DR. KUBER PRASAD GHIMIRE M.D. (NPI 1205115359) is an individual internal medicine provider in High Point, North Carolina, licensed in North Carolina (2016-01677) and active in the NPI registry since August 2011. He is enrolled in Medicare PECOS, is affiliated with Moses H. Cone Memorial Hospital, The, and maintains a secondary practice location in Darby.

NPPES Registry Identity

NPI1205115359
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. KUBER PRASAD GHIMIRECredential: M.D.
Location Address601 N ELM STHigh Point, NC 27262-4331
Mailing Address1500 Lansdowne AveDarby, PA 19023-1200 · (610) 237-4000
Phone(336) 716-2255
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateAugust 8, 2011
Last NPPES UpdateSeptember 10, 2020
NPPES CertifiedSeptember 10, 2020
✔ NPI 1205115359 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in NC · 2016-01677✔ Licensed in PA · 198530
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.
601 N ELM ST, High Point, NC 27262
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Secondary Practice Location 1

Location 11500 Lansdowne AveDarby, PA 19023-1200 · Phone (610) 237-4000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina and more.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. Kuber Prasad Ghimire 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 ID2163640905
PECOS Enrollment IDI20170418000818
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

5

Medicare enrollment records show Kuber Ghimire reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

High Point Regional Health
Same address
General Acute Care Hospital
601 N ELM ST
High Point, NC 27262
  • Reassigned Medicare billing, North Carolina enrollment
  • 29 clinicians in this Medicare group
NPI 1396746228 (336) 878-6000
Moses Cone Physician Services, Inc.
11 mi
Internal Medicine
104 POMONA DR
Greensboro, NC 27407
  • Reassigned Medicare billing, North Carolina enrollment
  • 691 clinicians in this Medicare group
NPI 1528664596 (336) 890-2474
Wake Forest University Health Sciences
14 mi
Multi-Specialty
1303 GREENSBORO STREET EXT
Lexington, NC 27295
  • Reassigned Medicare billing, North Carolina enrollment
  • 3,003 clinicians in this Medicare group
NPI 1639454499 (336) 716-2255
Hospitalist Medicine Physicians Of North Carolina PLLC
16 mi
Internal Medicine
1200 N ELM ST, 5TH FLOOR
Greensboro, NC 27401
  • Reassigned Medicare billing, North Carolina enrollment
  • 254 clinicians in this Medicare group
NPI 1164724902 (336) 832-5777
Cogent Healthcare Of North Carolina, PC
121 mi
Internal Medicine
2460 CURTIS ELLIS DR
Rocky Mount, NC 27804
  • Reassigned Medicare billing, North Carolina enrollment
  • 393 clinicians in this Medicare group
NPI 1548207483 (828) 456-7311

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 3

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.
432 services165 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.
150 services147 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.
15 services14 patients

Hospital Affiliations CMS Care Compare

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

Moses H. Cone Memorial Hospital, The

Acute Care Hospitals · Greensboro, NC
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340091
Location1200 N Elm StGreensboro, NC 27401 · Guilford County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27262 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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.

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 suppliers24 claims24 services$67.39 avg. paid by Medicare
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738
DME-Oxygen and Supplies · category DC000N
1 supplier22 claims22 services$29.59 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.

DR. GRACE CATHERINE DANBY MD
Emergency Medicine
601 N ELM ST
HIGH POINT, NC 27262
Guilford County (336) 878-6000
SARAH MALIK MD
Hospitalist
601 N ELM ST
HIGH POINT, NC 27262
Guilford County (336) 716-2255
LEONA SATCHWELL RN
Registered Nurse (Medical-Surgical)
601 N ELM ST
HIGH POINT, NC 27262
Guilford County (336) 905-4227
WAKE FOREST UNIVERSITY HEALTH SCIENCES
Durable Medical Equipment & Medical Supplies
601 N ELM ST
HIGH POINT, NC 27262
Guilford County (336) 878-6000
SANDRA BAFFOUR KYEI ACNPC-AG
Nurse Practitioner
601 N ELM ST
HIGH POINT, NC 27262
Guilford County (336) 972-0792
ALLISON PAIGE O'NEILL PA-C
Physician Assistant
601 N ELM ST
HIGH POINT, NC 27262
Guilford County (336) 878-6000
LAUREN NICOLE COZART CRNA
Nurse Anesthetist, Certified Registered
601 N ELM ST
HIGH POINT, NC 27262
Guilford County (336) 878-6000
MICKAYLA DIANE GREAGAN PA-C
Physician Assistant
601 N ELM ST
HIGH POINT, NC 27262
Guilford County (518) 928-7884

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 Kuber Ghimire's NPI number?

The NPI number for Kuber Ghimire is 1205115359. It was assigned to this individual provider in the NPPES registry on August 8, 2011.

Where is Kuber Ghimire located?

Kuber Ghimire practices at 601 N Elm St, High Point, NC 27262. The listed phone number is (336) 716-2255.

What is Kuber Ghimire's specialty?

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

Is Kuber Ghimire enrolled in Medicare?

Yes. Kuber 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 Kuber Ghimire's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kuber Ghimire reassigns Medicare benefits to 5 organizations: High Point Regional Health (High Point, NC), Moses Cone Physician Services, Inc. (Greensboro, NC), Wake Forest University Health Sciences (Lexington, NC), Hospitalist Medicine Physicians Of North Carolina PLLC (Greensboro, NC) and Cogent Healthcare Of North Carolina, PC (Rocky Mount, NC). 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 Kuber Ghimire's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kuber Ghimire accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and AmeriHealth Caritas Next and 3 other insurers list Kuber 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 Kuber Ghimire affiliated with any hospitals?

According to CMS data, Kuber Ghimire is affiliated with Moses H. Cone Memorial Hospital, The.

When was this NPI record last updated?

The NPPES record for Kuber Ghimire was last updated on September 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.