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DR. BINITA SAPKOTA MD
NPI 1386029981
Internal Medicine - Rheumatology in Cleveland, OH

Active since July 23, 2015PECOS EnrolledAccepts Medicare Assignment
9500 EUCLID AVE, CLEVELAND, OH 44195(216) 444-5728 Get Directions Write a Review

NPPES record last updated: August 11, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 11, 2022, Feb 11, 2019 (2 updates tracked since 2019).

About Dr. Binita Sapkota Md NPPES

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

DR. BINITA SAPKOTA MD (NPI 1386029981) is an individual rheumatology provider in Cleveland, Ohio, licensed in Ohio (35.144923) and active in the NPI registry since July 2015. She is enrolled in Medicare PECOS, is affiliated with Cleveland Clinic, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1386029981
Entity TypeIndividualFemale
Primary Taxonomy207RR0500X
Provider Legal NameDR. BINITA SAPKOTACredential: MD
Location Address9500 EUCLID AVECleveland, OH 44195
Mailing Address9500 Euclid AveCleveland, OH 44195-0001
Phone(216) 444-5728
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateJuly 23, 2015
Last NPPES UpdateAugust 11, 20222 updates tracked since enumeration
NPPES CertifiedAugust 11, 2022
✔ NPI 1386029981 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians
Taxonomy Code207RR0500X
License✔ Licensed in OH · 35.144923
Definition
An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.
Also ListedInternal MedicineTaxonomy 207R00000X · License 080696 (GA)
9500 EUCLID AVE, Cleveland, OH 44195
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11412 Milstead Ave NEConyers, GA 30012-3877 · Phone (770) 918-3000 · Fax (770) 918-3104
Location 21650 Selwyn AveBronx, NY 10457-7626 · Phone (646) 420-8313

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Insurance Corporation of Ohio.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

Dr. Binita Sapkota 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 ID8426301722
PECOS Enrollment IDI20220815003029
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 6

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 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.
99 services62 patients
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.
52 services46 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.
38 services22 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
34 services34 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
33 services33 patients
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.
17 services17 patients

Hospital Affiliations CMS Care Compare 2

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

Cleveland Clinic

Acute Care Hospitals · Cleveland, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360180
Location9500 Euclid AvenueCleveland, OH 44195 · Cuyahoga County
Emergency services Birthing friendly

Cleveland Clinic Avon Hospital

Acute Care Hospitals · Avon, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360364
Location33300 Cleveland Clinic BlvdAvon, OH 44011 · Lorain County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44195 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
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
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.

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…
100%49 patients5/55-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.

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.

MS. MARY COLLEEN RATH R.D., L.D., CNSC
Dietitian, Registered
9500 EUCLID AVE, M17
CLEVELAND, OH 44195
Cuyahoga County (216) 444-6986
DR. CHRISTOPHER F TENGGARDJAJA M.D.
Urology (Urogynecology and Reconstructive Pelvic Surgery)
9500 EUCLID AVE, Q10-1
CLEVELAND, OH 44195
Cuyahoga County (216) 444-5600
DR. MASATO FUJIKI M.D., PH.D.
Surgery
9500 EUCLID AVE
CLEVELAND, OH 44195
Cuyahoga County (216) 444-8007
KRISTIN R JOHNSON CNP
Nurse Practitioner
9500 EUCLID AVE
CLEVELAND, OH 44195
Cuyahoga County (800) 223-2273
MONICA LYNN SHEIN CRNA
Nurse Anesthetist, Certified Registered
9500 EUCLID AVE
CLEVELAND, OH 44195
Cuyahoga County (800) 223-2273
MRS. TONYA RENEE GOINGS ACNP-BC
Nurse Practitioner (Acute Care)
9500 EUCLID AVE, SUITE RC25
CLEVELAND, OH 44195
Cuyahoga County (216) 444-2200
MS. DANA ANNE RUBIS CNP
Nurse Practitioner (Critical Care Medicine)
9500 EUCLID AVE, G58
CLEVELAND, OH 44195
Cuyahoga County (216) 444-5086
DR. RACHAEL C SULLIVAN M.D.
Surgery
9500 EUCLID AVE
CLEVELAND, OH 44195
Cuyahoga County (440) 449-1101

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 Binita Sapkota's NPI number?

The NPI number for Binita Sapkota is 1386029981. It was assigned to this individual provider in the NPPES registry on July 23, 2015.

Where is Binita Sapkota located?

Binita Sapkota practices at 9500 Euclid Ave, Cleveland, OH 44195. The listed phone number is (216) 444-5728.

What is Binita Sapkota's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Binita Sapkota enrolled in Medicare?

Yes. Binita Sapkota 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 Binita Sapkota accept?

Health plans from Oscar Insurance Corporation of Ohio list Binita Sapkota 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 Binita Sapkota affiliated with any hospitals?

According to CMS data, Binita Sapkota is affiliated with Cleveland Clinic and Cleveland Clinic Avon Hospital.

When was this NPI record last updated?

The NPPES record for Binita Sapkota was last updated on August 11, 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.