1. Home
  2. Directory
  3. Florida
  4. Gainesville
  5. Internal Medicine
  6. NPI Profile

DR. PUSHPA RAJ POUDEL MD
NPI 1306158035
Internal Medicine in Gainesville, FL

Active since July 10, 2010PECOS EnrolledAccepts Medicare Assignment
89.89/100
CMS Quality Rating
1600 SW ARCHER RD, GAINESVILLE, FL 32610(352) 265-5911(352) 265-5606 Get Directions Write a Review

NPPES record last updated: August 22, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 6, 2024, Mar 18, 2016, Dec 10, 2015 (3 updates tracked since 2015).

About Dr. Pushpa Raj Poudel Md NPPES

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

DR. PUSHPA RAJ POUDEL MD (NPI 1306158035) is an individual internal medicine provider in Gainesville, Florida, licensed in Florida (ME125134) and active in the NPI registry since July 2010. He is enrolled in Medicare PECOS, is affiliated with Carolinas Medical Center-northeast, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1306158035
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. PUSHPA RAJ POUDELCredential: MD
Location Address1600 SW ARCHER RDGainesville, FL 32610-2346
Mailing AddressPo Box 100186Gainesville, FL 32610-0186 · (352) 265-5911 · Fax (352) 265-5606
Phone(352) 265-5911
Fax(352) 265-5606
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateJuly 10, 2010
Last NPPES UpdateAugust 22, 20253 updates tracked since enumeration
NPPES CertifiedAugust 22, 2025
✔ NPI 1306158035 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · ME125134
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.
Also ListedHospitalistTaxonomy 208M00000X · License ME125134 (FL), 2014-02134 (NC)
1600 SW ARCHER RD, Gainesville, FL 32610
Open in Google Maps ↗

Secondary Practice Locations 3

Location 1200 SE Hospital AveStuart, FL 34994-2346 · Phone (772) 223-5618 · Fax (772) 288-5834
Location 22700 Wayne Memorial DrGoldsboro, NC 27534-9494 · Phone (919) 587-4394 · Fax (919) 587-2998
Location 3612 Mocksville AveSalisbury, NC 28144-2732 · Phone (704) 210-5260 · Fax (704) 210-5265

Other Identifiers 2

Medicaid015781700FL
Other0L8A0FL · Florida Blue

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare.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. Pushpa Raj Poudel Md 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 ID4981737624
PECOS Enrollment IDI20171005000864
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 Reassignments

5

Medicare enrollment records show Pushpa Poudel reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Florida Clinical Practice Association Inc
Same address
Surgery
1600 SW ARCHER RD
Gainesville, FL 32610
  • Reassigned Medicare billing, Florida enrollment
  • 3,324 clinicians in this Medicare group
NPI 1063463768 (352) 265-7922
Hospital Physician Services - Southeast Professional Corporation
298 mi
Hospitalist
2151 W SPRING ST
Monroe, GA 30655
  • Reassigned Medicare billing, North Carolina enrollment
  • 511 clinicians in this Medicare group
NPI 1760410385 (770) 267-8461
Novant Health Medical Group, LLC
368 mi
Urology
75 EMERSON BAY RD, SUITE 102
Carolina Shores, NC 28467
  • Reassigned Medicare billing, North Carolina enrollment
  • 2,998 clinicians in this Medicare group
NPI 1356705479 (910) 721-4000
Carolinas Physicians Network Inc
376 mi
Pediatrics
1656 RIVERCHASE BLVD, STE 3400
Rock Hill, SC 29732
  • Reassigned Medicare billing, North Carolina enrollment
  • 1,646 clinicians in this Medicare group
NPI 1235148529 (803) 328-6281
Unc Physicians Network, LLC
419 mi
Cardiovascular Disease
205 PAGE RD
Pinehurst, NC 28374
  • Reassigned Medicare billing, North Carolina enrollment
  • 1,337 clinicians in this Medicare group
NPI 1396174363 (910) 295-5511

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 7

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.

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.
235 services138 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
213 services125 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
184 services179 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
45 services45 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
21 services21 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
21 services19 patients

Hospital Affiliations CMS Care Compare 5

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

Carolinas Medical Center-Northeast

Acute Care Hospitals · Concord, NC
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340001
Location920 Church St NConcord, NC 28025 · Cabarrus County
Emergency services Birthing friendly

Unc Health Wayne

Acute Care Hospitals · Goldsboro, NC
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340010
Location2700 Wayne Memorial DrGoldsboro, NC 27534 · Wayne County
Emergency services Birthing friendly

Novant Health Brunswick Medical Center

Acute Care Hospitals · Supply, NC
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number340158
Location1 Medical Center Dr PO Box 139Supply, NC 28462 · Brunswick County
Emergency services Birthing friendly

Atrium Health University City

Acute Care Hospitals · Charlotte, NC
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340166
Location8800 North Tyron StreetCharlotte, NC 28262 · Mecklenburg County
Emergency services Birthing friendly

Novant Health Mint Hill Medical Center

Acute Care Hospitals · Charlotte, NC
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340190
Location8201 Healthcare LoopCharlotte, NC 28215 · Mecklenburg County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32610 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
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

89.89/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality75.75
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims

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

Nebulizer, with compressor E0570
DME-Other DME · category DE000N
2 suppliers31 claims31 services$4.94 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.

DR. BAHAREH EBADIFAR KEITH DO
Pediatrics
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 273-0462
AFRASYAB KHAN
Surgery
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 265-0680
GULSUN ERDAG MD
Pathology (Anatomic Pathology & Clinical Pathology)
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 265-9900
DR. ALBERT H. MATTIA D.D.S.
Dentist (Prosthodontics)
1600 SW ARCHER RD, D4-4
GAINESVILLE, FL 32610
Alachua County (352) 273-5801
JOANNA CHAFFIN
Pathology (Anatomic Pathology & Clinical Pathology)
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 627-9272
DR. CASEY JUSTIN BEAL MD
Ophthalmology
1600 SW ARCHER RD, BOX 100284
GAINESVILLE, FL 32610
Alachua County (352) 273-8778
WILLIAM CRAIG HICKS CRNA
Nurse Anesthetist, Certified Registered
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 273-6438
HENRY FONTILLAS PATALINGHUG CRNA
Nurse Anesthetist, Certified Registered
1600 SW ARCHER RD
GAINESVILLE, FL 32610
Alachua County (352) 273-6438

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 Pushpa Poudel's NPI number?

The NPI number for Pushpa Poudel is 1306158035. It was assigned to this individual provider in the NPPES registry on July 10, 2010.

Where is Pushpa Poudel located?

Pushpa Poudel practices at 1600 SW Archer Rd, Gainesville, FL 32610. The listed phone number is (352) 265-5911.

What is Pushpa Poudel's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Pushpa Poudel enrolled in Medicare?

Yes. Pushpa Poudel 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.

Which organizations bill Medicare for Pushpa Poudel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Pushpa Poudel reassigns Medicare benefits to 5 organizations: Florida Clinical Practice Association Inc (Gainesville, FL), Hospital Physician Services - Southeast Professional Corporation (Monroe, GA), Novant Health Medical Group, LLC (Carolina Shores, NC), Carolinas Physicians Network Inc (Rock Hill, SC) and Unc Physicians Network, LLC (Pinehurst, NC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Pushpa Poudel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Pushpa Poudel accept?

Health plans from Cigna Healthcare list Pushpa 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.

Is Pushpa Poudel affiliated with any hospitals?

According to CMS data, Pushpa Poudel is affiliated with Carolinas Medical Center-Northeast, Unc Health Wayne, Novant Health Brunswick Medical Center, Atrium Health University City and Novant Health Mint Hill Medical Center.

When was this NPI record last updated?

The NPPES record for Pushpa Poudel was last updated on August 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.