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PRIMA POUDEL M.D.
NPI 1235446436
Hospitalist in San Antonio, TX

Active since September 09, 2010PECOS Enrolled
4502 MEDICAL DR APT 45, SAN ANTONIO, TX 78229(210) 358-4000 Get Directions Write a Review

NPPES record last updated: October 11, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Prima Poudel M.d. NPPES

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

PRIMA POUDEL M.D. (NPI 1235446436) is an individual hospitalist provider in San Antonio, Texas, licensed in Texas (W9884) and active in the NPI registry since September 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235446436
Entity TypeIndividualFemale
Primary Taxonomy208M00000X
Provider Legal NamePRIMA POUDELCredential: M.D.
Location Address4502 MEDICAL DR APT 45San Antonio, TX 78229-4402
Mailing Address4502 Medical Dr Apt 45San Antonio, TX 78229-4402 · (210) 358-4000
Phone(210) 358-4000
Sole ProprietorYes
Enumeration DateSeptember 9, 2010
Last NPPES UpdateOctober 11, 2019
✔ NPI 1235446436 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in TX · W9884
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
4502 MEDICAL DR APT 45, San Antonio, TX 78229
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Other Identifiers 1

Medicaid370303505TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan, Imperial Insurance Companies, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Prima Poudel M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78229 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
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.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
83%221 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers19 claims19 services$13.30 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
2 suppliers13 claims13 services$63.80 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Prima Poudel's NPI number?

The NPI number for Prima Poudel is 1235446436. It was assigned to this individual provider in the NPPES registry on September 9, 2010.

Where is Prima Poudel located?

Prima Poudel practices at 4502 Medical Dr Apt 45, San Antonio, TX 78229. The listed phone number is (210) 358-4000.

What is Prima Poudel's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Prima Poudel enrolled in Medicare?

Yes. Prima Poudel is registered in the Medicare PECOS enrollment system.

What insurance does Prima Poudel accept?

Health plans from Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan and Imperial Insurance Companies, Inc. list Prima Poudel 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.

When was this NPI record last updated?

The NPPES record for Prima Poudel was last updated on October 11, 2019. 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.