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ISHAN POUDEL MD
NPI 1356965057
Student in an Organized Health Care Education/Training Program in Brooklyn, NY

Active since May 29, 2020PECOS Enrolled
760 BROADWAY, WOODHULL MEDICAL AND MENTAL HEALTH CENTER, GME - ROOM 10A216, BROOKLYN, NY 11206(718) 963-8779 Get Directions Write a Review

NPPES record last updated: February 2, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 8, 2026, Jul 11, 2023, Jul 9, 2023 and 2 more (5 updates tracked since 2020).

About Ishan Poudel Md NPPES

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

ISHAN POUDEL MD (NPI 1356965057) is an individual student in an organized health care education/training program in Brooklyn, New York and active in the NPI registry since May 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1356965057
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameISHAN POUDELCredential: MD
Location Address760 BROADWAY, WOODHULL MEDICAL AND MENTAL HEALTH CENTER, GME - ROOM 10A216Brooklyn, NY 11206
Mailing Address760 Broadway, Woodhull Medical Center, Gme - Room 10a216Brooklyn, NY 11206 · (718) 963-8779 · Fax (718) 963-7957
Phone(718) 963-8779
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateMay 29, 2020
Last NPPES UpdateFebruary 2, 20225 updates tracked since enumeration
NPPES CertifiedFebruary 2, 2022
✔ NPI 1356965057 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
760 BROADWAY, WOODHULL MEDICAL AND MENTAL HEALTH CENTER, Brooklyn, NY 11206
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ishan Poudel Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7012472004
PECOS Enrollment IDI20260721000645
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 Ishan Poudel reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

St Josephs Medical Group PC
18 mi
Internal Medicine
703 MAIN ST
Paterson, NJ 07503
  • Reassigned Medicare billing, New Jersey enrollment
  • 317 clinicians in this Medicare group
NPI 1205425519 (973) 754-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Ishan Poudel's NPI number?

The NPI number for Ishan Poudel is 1356965057. It was assigned to this individual provider in the NPPES registry on May 29, 2020.

Where is Ishan Poudel located?

Ishan Poudel practices at 760 Broadway, Woodhull Medical And Mental Health Center Gme - Room 10a216, Brooklyn, NY 11206. The listed phone number is (718) 963-8779.

What is Ishan Poudel's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Ishan Poudel enrolled in Medicare?

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

Which organization bills Medicare for Ishan Poudel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ishan Poudel reassigns Medicare benefits to St Josephs Medical Group PC (Paterson, NJ). The 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 Ishan Poudel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Ishan Poudel was last updated on February 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.