DR. BIBEK KOIRALA M.D.
NPI 1215169735
Internal Medicine - Infectious Disease in Worcester, MA

Q: What is Bibek Koirala's NPI number?

The NPI number for Bibek Koirala is 1215169735. It was assigned to this individual provider in the NPPES registry on August 17, 2009.

Q: What is Bibek Koirala's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Q: When was this NPI record last updated?

The NPPES record for Bibek Koirala was last updated on February 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since August 17, 2009PECOS EnrolledAccepts Medicare Assignment

97.02/100

CMS Quality Rating

55 LAKE AVE N, WORCESTER, MA 01655(508) 334-8515(508) 334-6490 Get Directions Write a Review

NPPES record last updated: February 5, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 5, 2026, Jan 27, 2022, Apr 10, 2017 (3 updates tracked since 2017).

On this page

About Dr. Bibek Koirala M.d. NPPES

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

DR. BIBEK KOIRALA M.D. (NPI 1215169735) is an individual infectious disease provider in Worcester, Massachusetts, licensed in Massachusetts (250308) and active in the NPI registry since August 2009. He is enrolled in Medicare PECOS, is affiliated with Umass Memorial Healthalliance Hospitals, and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1215169735

Entity TypeIndividualMale

Primary Taxonomy207RI0200X

Provider Legal NameDR. BIBEK KOIRALACredential: M.D.

Location Address55 LAKE AVE NWorcester, MA 01655-0002

Mailing AddressPo Box 415348Boston, MA 02241-5348 · (800) 225-8885 · Fax (508) 334-1977

Phone(508) 334-8515

Fax(508) 334-6490

Sole ProprietorYes

Medical School CMSOtherGraduated 2007

Enumeration DateAugust 17, 2009

Last NPPES UpdateFebruary 5, 20263 updates tracked since enumeration

NPPES CertifiedFebruary 5, 2026

✔ NPI 1215169735 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RI0200X

License✔ Licensed in MA · 250308

Definition

An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.

Also ListedInternal MedicineTaxonomy 207R00000X · License 250308 (MA)

55 LAKE AVE N, Worcester, MA 01655

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Secondary Practice Locations 4

Location 160 Hospital RdLeominster, MA 01453-2205 · Phone (978) 466-4600

Location 255 Sayles StSouthbridge, MA 01550-1729 · Phone (508) 764-2400

Location 314 Prospect StMilford, MA 01757-3003 · Phone (508) 902-9751

Location 4119 Belmont StWorcester, MA 01605-2903 · Phone (508) 334-8515 · Fax (508) 334-6490

Accepted Insurance

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

Dr. Bibek 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 ID5092971002

PECOS Enrollment IDI20250519001918, I20260401004084

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.

Hospital Affiliations CMS Care Compare 3

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

Umass Memorial Healthalliance Hospitals

Acute Care Hospitals · Leominster, MA

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number220001

Location60 Hospital RoadLeominster, MA 01453 · Worcester County

Emergency services

Milford Regional Medical Center

Acute Care Hospitals · Milford, MA

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number220090

Location14 Prospect StreetMilford, MA 01757 · Worcester County

Emergency services Birthing friendly

Umass Memorial Medical Center/University Campus

Acute Care Hospitals · Worcester, MA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220163

Location55 Lake Avenue NorthWorcester, MA 01655 · Worcester County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01655 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

$134.47 typical visit price

range $58.86 – $177.36

Typical copayment $33.61 (range $14.71 – $44.34)

Most-billed visit code 99204

Established Patient

$103.48 typical visit price

range $19.11 – $144.84

Typical copayment $25.87 (range $4.77 – $36.21)

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.

97.02/100

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

Scored through an Alternative Payment Model

Quality

78.09

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims

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

1 supplier15 claims15 services$67.98 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.

HILLARY R. IRONS MD

Emergency Medicine

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 421-1400

MS. EILEEN A. DUHAMEL NP

Nurse Practitioner

55 LAKE AVE N, DEPARTMENT OF RADIOLOGY
WORCESTER, MA 01655

Worcester County (508) 334-2710

EWA HRYNISZYN CRNA

Nurse Anesthetist, Certified Registered

55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01655

Worcester County (508) 334-3271

HELEN COPSEY PA-C

Physician Assistant

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 334-8585

DR. ADEPEJU GBADEBO CHAMPION M.D.

Internal Medicine

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 334-2731

SOWMYA KORAPATI

Internal Medicine (Hematology & Oncology)

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 334-3550

LAYLA FAKHRZADEH M.D.

Anesthesiology

55 LAKE AVE N, ANESTHESIOLOGY
WORCESTER, MA 01655

Worcester County (508) 334-3271

YOONYIE CHO M.D.

Anesthesiology

55 LAKE AVE N
WORCESTER, MA 01655

Worcester County (508) 334-1000

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 Bibek Koirala's NPI number?

The NPI number for Bibek Koirala is 1215169735. It was assigned to this individual provider in the NPPES registry on August 17, 2009.

Where is Bibek Koirala located?

Bibek Koirala practices at 55 Lake Ave N, Worcester, MA 01655. The listed phone number is (508) 334-8515.

What is Bibek Koirala's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Bibek Koirala enrolled in Medicare?

Yes. Bibek Koirala 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 Bibek Koirala accept?

Health plans from Anthem Blue Cross and Blue Shield list Bibek Koirala 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 Bibek Koirala affiliated with any hospitals?

According to CMS data, Bibek Koirala is affiliated with Umass Memorial Healthalliance Hospitals, Milford Regional Medical Center and Umass Memorial Medical Center/University Campus.

When was this NPI record last updated?

The NPPES record for Bibek Koirala was last updated on February 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.