AJAY DHAKAL M.B.B.S.
NPI 1235493594
Internal Medicine - Hematology in Rochester, NY

Active since July 01, 2012PECOS EnrolledAccepts Medicare Assignment
76.84/100
CMS Quality Rating
601 ELMWOOD AVE, ROCHESTER, NY 14642(585) 275-5863 Get Directions Write a Review

NPPES record last updated: June 30, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 10, 2018, May 10, 2018, Apr 20, 2018 (3 updates tracked since 2018).

About Ajay Dhakal M.b.b.s. NPPES

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

AJAY DHAKAL M.B.B.S. (NPI 1235493594) is an individual hematology provider in Rochester, New York, licensed in New York (290727) and active in the NPI registry since July 2012. He is enrolled in Medicare PECOS, is affiliated with F F Thompson Hospital, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1235493594
Entity TypeIndividualMale
Primary Taxonomy207RH0000X
Provider Legal NameAJAY DHAKALCredential: M.B.B.S.
Location Address601 ELMWOOD AVERochester, NY 14642-2916
Mailing Address601 Elmwood Ave Box 704Rochester, NY 14642-0001 · (585) 275-3746
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateJuly 1, 2012
Last NPPES UpdateJune 30, 20233 updates tracked since enumeration
NPI 1235493594 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · HematologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0000X
License Licensed in NY · 290727
Definition

An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, clotting disorders, sickle cell disease, hemophilia, leukemia and lymphoma.

Also ListedInternal Medicine · Hematology & OncologyTaxonomy 207RH0003X · License 290727 (NY)
601 ELMWOOD AVE, Rochester, NY 14642

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

Ajay Dhakal M.b.b.s. 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 ID7113272253
PECOS Enrollment IDI20180614000033
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 2

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 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.
99 services38 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.
17 services14 patients

Hospital Affiliations CMS Care Compare 4

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

F F Thompson Hospital

Acute Care Hospitals · Canandaigua, NY
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330074
Location350 Parrish StreetCanandaigua, NY 14424 · Ontario County
Emergency services Birthing friendly

Highland Hospital

Acute Care Hospitals · Rochester, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330164
Location1000 South AvenueRochester, NY 14617 · Monroe County
Emergency services Birthing friendly

Nicholas H Noyes Memorial Hospital

Acute Care Hospitals · Dansville, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330238
Location111 Clara Barton StreetDansville, NY 14437 · Livingston County
Emergency services Birthing friendly

Strong Memorial Hospital

Acute Care Hospitals · Rochester, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330285
Location601 Elmwood AveRochester, NY 14642 · Monroe County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14642 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.

76.84/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality68.2
Promoting Interoperability100
Improvement Activities40
Cost42.68

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.

Physician Assistant
601 ELMWOOD AVE
ROCHESTER, NY 14642
Pediatrics (Neonatal-Perinatal Medicine)
601 ELMWOOD AVE, BOX 635
ROCHESTER, NY 14642
Radiology (Diagnostic Radiology)
601 ELMWOOD AVE, BOX 648
ROCHESTER, NY 14642
Nurse Practitioner (Family)
601 ELMWOOD AVE, BOX 652
ROCHESTER, NY 14642
Urology (Pediatric Urology)
601 ELMWOOD AVE, BOX 656
ROCHESTER, NY 14642
Nurse Practitioner (Adult Health)
601 ELMWOOD AVE, BOX 704
ROCHESTER, NY 14642
Student in an Organized Health Care Education/Training Program
601 ELMWOOD AVE, BOX 705
ROCHESTER, NY 14642
Radiology (Diagnostic Radiology)
601 ELMWOOD AVE
ROCHESTER, NY 14642

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 Ajay Dhakal's NPI number?

The NPI number for Ajay Dhakal is 1235493594. It was assigned to this individual provider in the NPPES registry on July 1, 2012.

Where is Ajay Dhakal located?

Ajay Dhakal practices at 601 Elmwood Ave, Rochester, NY 14642. The listed phone number is (585) 275-5863.

What is Ajay Dhakal's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology, with taxonomy code 207RH0000X.

Is Ajay Dhakal enrolled in Medicare?

Yes. Ajay Dhakal is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Ajay Dhakal affiliated with any hospitals?

According to CMS data, Ajay Dhakal is affiliated with F F Thompson Hospital, Highland Hospital, Nicholas H Noyes Memorial Hospital and Strong Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Ajay Dhakal was last updated on June 30, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.