PRAKASH SHRESTHA
NPI 1407253016
Hospitalist in Rochester, NY

Active since November 25, 2014PECOS EnrolledAccepts Medicare Assignment
95.19/100
CMS Quality Rating
1425 PORTLAND AVE, ROCHESTER, NY 14621(585) 922-5067 Get Directions Write a Review

NPPES record last updated: December 9, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Prakash Shrestha NPPES

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

PRAKASH SHRESTHA (NPI 1407253016) is an individual hospitalist provider in Rochester, New York, licensed in New York (285438) and active in the NPI registry since November 2014. He is enrolled in Medicare PECOS, is affiliated with Rochester General Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1407253016
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NamePRAKASH SHRESTHA
Location Address1425 PORTLAND AVERochester, NY 14621-3001
Mailing Address100 Kings Highway South, Fresh MeadowsRochester, NY 14617-5504 · (585) 922-0553
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateNovember 25, 2014
Last NPPES UpdateDecember 9, 2018
NPI 1407253016 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License Licensed in NY · 285438
Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

1425 PORTLAND AVE, Rochester, NY 14621

Secondary Practice Locations 2

Location 11200 Driving Park AveNewark, NY 14513-1090 · Phone (315) 359-2847 · Fax (315) 359-2806
Location 22 Coulter RoadClifton Springs, NY 14432-1122 · Phone (315) 462-1472 · Fax (315) 462-2639

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

Prakash Shrestha 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 ID1850687773
PECOS Enrollment IDI20160901000895
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 4

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 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.
225 services97 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.
128 services62 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.
32 services31 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.
29 services29 patients

Hospital Affiliations CMS Care Compare 2

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

Rochester General Hospital

Acute Care Hospitals · Rochester, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330125
Location1425 Portland AvenueRochester, NY 14621 · Monroe County
Emergency services Birthing friendly

Unity Hospital

Acute Care Hospitals · Rochester, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330226
Location1555 Long Pond RoadRochester, NY 14626 · Monroe County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14621 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
$126.40 typical visit price
range $54.87 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
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.

95.19/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality70.62
Promoting Interoperability100
Improvement Activities40

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.

Internal Medicine
1425 PORTLAND AVE
ROCHESTER, NY 14621
Pediatrics
1425 PORTLAND AVE, BOX 238
ROCHESTER, NY 14621
Radiology (Diagnostic Radiology)
1425 PORTLAND AVE
ROCHESTER, NY 14621
Pediatrics
1425 PORTLAND AVE
ROCHESTER, NY 14621
Radiology (Diagnostic Radiology)
1425 PORTLAND AVE
ROCHESTER, NY 14621
Pediatrics
1425 PORTLAND AVE, BOX 238
ROCHESTER, NY 14621
Psychiatry & Neurology (Geriatric Psychiatry)
1425 PORTLAND AVE
ROCHESTER, NY 14621
Radiology (Diagnostic Radiology)
1425 PORTLAND AVE
ROCHESTER, NY 14621

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 Prakash Shrestha's NPI number?

The NPI number for Prakash Shrestha is 1407253016. It was assigned to this individual provider in the NPPES registry on November 25, 2014.

Where is Prakash Shrestha located?

Prakash Shrestha practices at 1425 Portland Ave, Rochester, NY 14621. The listed phone number is (585) 922-5067.

What is Prakash Shrestha's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Prakash Shrestha enrolled in Medicare?

Yes. Prakash Shrestha 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 Prakash Shrestha affiliated with any hospitals?

According to CMS data, Prakash Shrestha is affiliated with Rochester General Hospital and Unity Hospital.

When was this NPI record last updated?

The NPPES record for Prakash Shrestha was last updated on December 9, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.