DR. SAPANA MAINALI M.D.
NPI 1235243726
Internal Medicine in State College, PA

Q: What is Sapana Mainali's NPI number?

The NPI number for Sapana Mainali is 1235243726. It was assigned to this individual provider in the NPPES registry on August 19, 2006.

Q: What is Sapana Mainali'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 Sapana Mainali was last updated on August 6, 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.

Active since August 19, 2006PECOS EnrolledAccepts Medicare Assignment

200 SCENERY DR, STATE COLLEGE, PA 16801(814) 231-4560(814) 231-6246 Get Directions Write a Review

NPPES record last updated: August 6, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Sapana Mainali M.d. NPPES

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

DR. SAPANA MAINALI M.D. (NPI 1235243726) is an individual internal medicine provider in State College, Pennsylvania, licensed in Pennsylvania (MD429734) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS, is affiliated with Geisinger Medical Center, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1235243726

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameDR. SAPANA MAINALICredential: M.D.

Location Address200 SCENERY DRState College, PA 16801-7974

Mailing Address100 N Academy AveDanville, PA 17822-3034 · (570) 271-6144 · Fax (570) 271-6578

Phone(814) 231-4560

Fax(814) 231-6246

Sole ProprietorNo

Medical School CMSOtherGraduated 2000

Enumeration DateAugust 19, 2006

Last NPPES UpdateAugust 6, 2020

NPPES CertifiedAugust 6, 2020

✔ NPI 1235243726 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in PA · MD429734

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.

200 SCENERY DR, State College, PA 16801

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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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Sapana Mainali 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 ID2567461098

PECOS Enrollment IDI20061212000106

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 Reassignment

Medicare enrollment records show Sapana Mainali reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Geisinger Clinic

Same address

Internal Medicine

200 SCENERY DR
State College, PA 16801

Reassigned Medicare billing, Pennsylvania enrollment
4,429 clinicians in this Medicare group

NPI 1093767915 (814) 231-4560

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 13

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.

325 services215 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.

114 services87 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

60 services59 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

51 services50 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.

49 services47 patients

Administration of vaccine 90471

Administering a vaccine involves injecting a small, safe piece of a virus or bacteria into your body. This triggers your immune system to recognize and fight off the disease in the future. It's a vital tool in preventing serious illnesses and maintaining public health.

24 services23 patients

Administration of hepatitis b vaccine G0010

The Hepatitis B vaccine is a preventive measure against the Hepatitis B virus. It is given as an injection into the muscle. The vaccine stimulates your body to produce antibodies, providing immunity against the virus. It's typically given in 3 doses over a 6-month period.

20 services12 patients

Hepatitis b vaccine, adult dosage (3 dose schedule) 90746

The Hepatitis B vaccine for adults is given in a 3-dose schedule to protect against the Hepatitis B virus. The first dose is given, followed by a second dose 1 month later, and a final dose 6 months after the first. It helps your body develop immunity to the virus.

19 services11 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

17 services14 patients

Blood test, clotting time 85610

A clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.

16 services15 patients

Anticoagulant management of patient taking warfarin 93793

Anticoagulant management with warfarin involves monitoring and adjusting your medication to prevent blood clots while minimizing the risk of bleeding. Regular blood tests measure your response to warfarin, helping adjust your dose if necessary. It's crucial to maintain a consistent diet and promptly report any changes in your health.

16 services15 patients

Routine electrocardiogram (ecg) using at least 12 leads with tracing 93005

An Electrocardiogram (ECG) is a simple, painless test that records the heart's electrical activity. Using 12 leads attached to your skin, it generates a tracing of your heart rhythm. It helps detect any heart problems by showing the timing and strength of electrical signals passing through each part of your heart.

11 services11 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

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

Geisinger-Lewistown Hospital

Acute Care Hospitals · Lewistown, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390048

Location400 Highland AvenueLewistown, PA 17044 · Mifflin County

Emergency services Birthing friendly

Mount Nittany Medical Center

Acute Care Hospitals · State College, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390268

Location1800 East Park AveState College, PA 16803 · Centre County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 16801 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 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Neuromuscular stimulator, electronic shock unit E0745

DME-Other DME · category DE000N

1 supplier11 claims11 services$68.11 avg. paid by Medicare

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 supplier26 claims26 services$75.99 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

2 suppliers29 claims29 services$183.12 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

4 suppliers11 claims11 services$23.59 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.

CIERA CUMMING

Pharmacist