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SUMIRA ADHIKARI KOIRALA M.D.
NPI 1245562685
Family Medicine in Boardman, OH

Active since February 10, 2010PECOS EnrolledAccepts Medicare Assignment
8423 MARKET ST, STE 101, BOARDMAN, OH 44512(330) 729-8700(330) 729-8701 Get Directions Write a Review

NPPES record last updated: December 28, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 28, 2016, Sep 30, 2015 (2 updates tracked since 2015).

About Sumira Adhikari Koirala M.d. NPPES

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

SUMIRA ADHIKARI KOIRALA M.D. (NPI 1245562685) is an individual family medicine provider in Boardman, Ohio, licensed in Ohio (35.098403) and active in the NPI registry since February 2010. She is enrolled in Medicare PECOS, is affiliated with St Elizabeth Youngstown Hospital, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1245562685
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameSUMIRA ADHIKARI KOIRALACredential: M.D.
Location Address8423 MARKET ST, STE 101Boardman, OH 44512-6778
Mailing Address8423 Market St, Ste 101Boardman, OH 44512-6778 · (330) 729-8700 · Fax (330) 729-8701
Phone(330) 729-8700
Fax(330) 729-8701
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateFebruary 10, 2010
Last NPPES UpdateDecember 28, 20162 updates tracked since enumeration
✔ NPI 1245562685 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OH · 35.098403
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
8423 MARKET ST, Boardman, OH 44512
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Other Identifiers 2

Medicaid0069459OH
Medicare PINH103160OH

Accepted Insurance

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

Sumira Adhikari Koirala 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 ID7315102522
PECOS Enrollment IDI20120712000636
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 9

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.
43 services36 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.
41 services31 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.
39 services15 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.
32 services28 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
27 services23 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.
26 services26 patients

Hospital Affiliations CMS Care Compare 2

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

St Elizabeth Youngstown Hospital

Acute Care Hospitals · Youngstown, OH
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number360064
Location1044 Belmont AvenueYoungstown, OH 44501 · Mahoning County
Emergency services

Hmhp St Elizabeth Boardman Health Center

Acute Care Hospitals · Boardman, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number360276
Location8401 Market StreetBoardman, OH 44512 · Mahoning County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44512 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

Other Providers at the Same Location NPPES 16

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

DIANNE WEISNER APN
Registered Nurse (Diabetes Educator)
8423 MARKET ST, BLDG C, SUITE 300
BOARDMAN, OH 44512
Mahoning County (330) 543-3276
MRS. FRANCHESSCA LUCIA CATALANO PA-C
Physician Assistant
8423 MARKET ST, STE 101
BOARDMAN, OH 44512
Mahoning County (330) 729-8700
MICHAEL ROBERT PASCOLINI D.O.
Otolaryngology (Facial Plastic Surgery)
8423 MARKET ST, STE 205
BOARDMAN, OH 44512
Mahoning County (330) 729-1934
THOMAS DONALD MACABOBBY M.D.
Family Medicine
8423 MARKET ST, STE 101
BOARDMAN, OH 44512
Mahoning County (330) 729-8700
CHRISTINA BROOKE WALKER D.O.
Emergency Medicine
8423 MARKET ST
BOARDMAN, OH 44512
Mahoning County (330) 729-8757
OSCAR FOUAD KHAWLI MD
Obstetrics & Gynecology (Maternal & Fetal Medicine)
8423 MARKET ST, STE 207
BOARDMAN, OH 44512
Mahoning County (330) 729-7901
DR. THOMAS JOSEPH ZARLINGO M.D.
Obstetrics & Gynecology (Maternal & Fetal Medicine)
8423 MARKET ST, STE 207
BOARDMAN, OH 44512
Mahoning County (330) 729-7901
CRYSCILLA MAYNARD PA-C
Physician Assistant
8423 MARKET ST, STE 205
BOARDMAN, OH 44512
Mahoning County (330) 729-1933

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 Sumira Koirala's NPI number?

The NPI number for Sumira Koirala is 1245562685. It was assigned to this individual provider in the NPPES registry on February 10, 2010.

Where is Sumira Koirala located?

Sumira Koirala practices at 8423 Market St Ste 101, Boardman, OH 44512. The listed phone number is (330) 729-8700.

What is Sumira Koirala's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Sumira Koirala enrolled in Medicare?

Yes. Sumira Koirala 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.

What insurance does Sumira Koirala accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 3 other insurers list Sumira Koirala 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.

Is Sumira Koirala affiliated with any hospitals?

According to CMS data, Sumira Koirala is affiliated with St Elizabeth Youngstown Hospital and Hmhp St Elizabeth Boardman Health Center.

When was this NPI record last updated?

The NPPES record for Sumira Koirala was last updated on December 28, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.