SUMAN THAPALIYA MD
NPI 1225559297
Internal Medicine in Danville, PA

Q: What is Suman Thapaliya's NPI number?

The NPI number for Suman Thapaliya is 1225559297. It was assigned to this individual provider in the NPPES registry on June 29, 2017.

Q: What is Suman Thapaliya's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Suman Thapaliya was last updated on February 11, 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 June 29, 2017PECOS EnrolledAccepts Medicare Assignment

100 N ACADEMY AVE, DANVILLE, PA 17822(570) 271-6164 Get Directions Write a Review

NPPES record last updated: February 11, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 11, 2021, Oct 14, 2020, Jun 29, 2017 (3 updates tracked since 2017).

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About Suman Thapaliya Md NPPES

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

SUMAN THAPALIYA MD (NPI 1225559297) is an individual internal medicine provider in Danville, Pennsylvania, licensed in Pennsylvania (MD471850) and active in the NPI registry since June 2017. He is enrolled in Medicare PECOS, is affiliated with Geisinger-bloomsburg Hospital, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1225559297

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameSUMAN THAPALIYACredential: MD

Location Address100 N ACADEMY AVEDanville, PA 17822-1122

Mailing Address100 N Academy AveDanville, PA 17822-4903 · (570) 271-6144 · Fax (570) 271-6578

Phone(570) 271-6164

Sole ProprietorNo

Medical School CMSOtherGraduated 2008

Enumeration DateJune 29, 2017

Last NPPES UpdateFebruary 11, 20213 updates tracked since enumeration

NPPES CertifiedFebruary 11, 2021

✔ NPI 1225559297 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in PA · MD471850

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.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

100 N ACADEMY AVE, Danville, PA 17822

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.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

Suman Thapaliya 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 ID941544506

PECOS Enrollment IDI20201013002827

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 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.

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.

113 services93 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.

99 services37 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.

30 services30 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.

30 services30 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.

28 services17 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.

25 services25 patients

Hospital Affiliations CMS Care Compare 4

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

Geisinger-Bloomsburg Hospital

Acute Care Hospitals · Bloomsburg, PA

OwnershipVoluntary non-profit - Private

CMS Certification Number390003

Location549 East Fair StreetBloomsburg, PA 17815 · Columbia County

Emergency services Birthing friendly

Geisinger Medical Center

Acute Care Hospitals · Danville, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390006

Location100 North Academy AvenueDanville, PA 17822 · Montour County

Emergency services Birthing friendly

Evangelical Community Hospital

Acute Care Hospitals · Lewisburg, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390013

LocationOne Hospital DriveLewisburg, PA 17837 · Union County

Emergency services Birthing friendly

Pottstown Hospital

Acute Care Hospitals · Pottstown, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390123

Location1600 East High StreetPottstown, PA 19464 · Montgomery County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 17822 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

$126.34 typical visit price

range $54.64 – $166.87

Typical copayment $31.58 (range $13.66 – $41.71)

Most-billed visit code 99204

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

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.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

5 suppliers11 claims37 services$6.36 avg. paid by Medicare

Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) E0630

DME-Other DME · category DE000N

1 supplier12 claims12 services$55.34 avg. paid by Medicare

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

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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. TARA JEAN LOUX MD

Surgery (Pediatric Surgery)