PRATIBHA PAUDEL FNP
NPI 1225629033
Nurse Practitioner - Family in Prosper, TX

Q: What is Pratibha Paudel's NPI number?

The NPI number for Pratibha Paudel is 1225629033. It was assigned to this individual provider in the NPPES registry on February 3, 2021.

Q: What is Pratibha Paudel's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Pratibha Paudel was last updated on April 4, 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 February 03, 2021PECOS EnrolledAccepts Medicare Assignment

86.29/100

CMS Quality Rating

201 S PRESTON RD, PROSPER, TX 75078(972) 347-6375 Get Directions Write a Review

NPPES record last updated: April 4, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 4, 2023, Feb 3, 2022, Jan 26, 2022 and 3 more (6 updates tracked since 2021).

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About Pratibha Paudel Fnp NPPES

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

PRATIBHA PAUDEL FNP (NPI 1225629033) is an individual family provider in Prosper, Texas, licensed in Texas (1020062) and active in the NPI registry since February 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1225629033

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NamePRATIBHA PAUDELCredential: FNP

Location Address201 S PRESTON RDProsper, TX 75078-8585

Mailing Address201 S Preston RdProsper, TX 75078-8585 · (972) 347-6375

Phone(972) 347-6375

Sole ProprietorYes

Medical School CMSOtherGraduated 2020

Enumeration DateFebruary 3, 2021

Last NPPES UpdateApril 4, 20236 updates tracked since enumeration

NPPES CertifiedApril 4, 2023

✔ NPI 1225629033 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in TX · 1020062

201 S PRESTON RD, Prosper, TX 75078

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Community Health Choice.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

Pratibha Paudel Fnp 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 ID8820493364

PECOS Enrollment IDI20210823001632

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 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.

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.

17 services15 patients

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.

16 services13 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

15 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75078 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

$84.92 typical visit price

range $54.84 – $166.88

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

Most-billed visit code 99203

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

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.

86.29/100

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

Scored as part of a group practice

Quality

79.36

Improvement Activities

Cost

92.14

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JEAN ANN CLARK MSRN, FNP-C

Nurse Practitioner (Family)