KRISHNA BILAS GHIMIRE MD
NPI 1225340359
Internal Medicine - Hematology & Oncology in Syracuse, NY

Q: What is Krishna Ghimire's NPI number?

The NPI number for Krishna Ghimire is 1225340359. It was assigned to this individual provider in the NPPES registry on July 6, 2010.

Q: What is Krishna Ghimire's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Q: When was this NPI record last updated?

The NPPES record for Krishna Ghimire was last updated on January 13, 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 06, 2010PECOS EnrolledAccepts Medicare Assignment

89.66/100

CMS Quality Rating

750 E ADAMS ST, SYRACUSE, NY 13210(315) 464-8200 Get Directions Write a Review

NPPES record last updated: January 13, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 13, 2023, May 14, 2020, Sep 22, 2016 (3 updates tracked since 2016).

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About Krishna Bilas Ghimire Md NPPES

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

KRISHNA BILAS GHIMIRE MD (NPI 1225340359) is an individual hematology & oncology provider in Syracuse, New York, licensed in New York (299580) and active in the NPI registry since July 2010. He is enrolled in Medicare PECOS, is affiliated with Wynn Hospital, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1225340359

Entity TypeIndividualMale

Primary Taxonomy207RH0003X

Provider Legal NameKRISHNA BILAS GHIMIRECredential: MD

Location Address750 E ADAMS STSyracuse, NY 13210-2306

Mailing Address750 E Adams StSyracuse, NY 13210-2306

Phone(315) 464-8200

Sole ProprietorNo

Medical School CMSOtherGraduated 2003

Enumeration DateJuly 6, 2010

Last NPPES UpdateJanuary 13, 20233 updates tracked since enumeration

NPPES CertifiedJanuary 13, 2023

✔ NPI 1225340359 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0003X

License✔ Licensed in NY · 299580

Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

750 E ADAMS ST, Syracuse, NY 13210

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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

Krishna Bilas 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 ID8325226178

PECOS Enrollment IDI20190823002780

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 9

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.

307 services127 patients

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

118 services61 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.

88 services20 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

47 services24 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.

24 services22 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

21 services21 patients

Hospital Affiliations CMS Care Compare 3

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

Wynn Hospital

Acute Care Hospitals · Utica, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330044

Location111 Hospital DriveUtica, NY 13502 · Oneida County

Emergency services Birthing friendly

Oneida Health Hospital

Acute Care Hospitals · Oneida, NY

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number330115

Location321 Genesee StreetOneida, NY 13421 · Madison County

Emergency services Birthing friendly

University Hospital S U N Y Health Science Center

Acute Care Hospitals · Syracuse, NY

3/5 CMS rating

OwnershipGovernment - State

CMS Certification Number330241

Location750 East Adams StreetSyracuse, NY 13210 · Onondaga County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13210 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

$166.88 typical visit price

range $54.87 – $166.88

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

Most-billed visit code 99205

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.

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.

89.66/100

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

Scored as part of a group practice

Quality

76.49

Promoting Interoperability

Improvement Activities

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.

DAVID M KANTER MD

Physical Medicine & Rehabilitation