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NIHAAL PRASHANT KARNIK MD
NPI 1407384852
Internal Medicine - Gastroenterology in Seattle, WA

Active since May 30, 2017PECOS EnrolledAccepts Medicare Assignment
1100 9TH AVE, SEATTLE, WA 98101(206) 223-2319(206) 341-1405 Get Directions Write a Review

NPPES record last updated: September 29, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Nihaal Prashant Karnik Md NPPES

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

NIHAAL PRASHANT KARNIK MD (NPI 1407384852) is an individual gastroenterology provider in Seattle, Washington, licensed in Washington (MD61414810) and active in the NPI registry since May 2017. He is enrolled in Medicare PECOS, is affiliated with Geisinger-community Medical Center, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1407384852
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameNIHAAL PRASHANT KARNIKCredential: MD
Location Address1100 9TH AVESeattle, WA 98101-2756
Mailing Address1100 9th AveSeattle, WA 98101-2756 · (206) 223-2319 · Fax (206) 341-1405
Phone(206) 223-2319
Fax(206) 341-1405
Sole ProprietorYes
Medical School CMSOtherGraduated 2016
Enumeration DateMay 30, 2017
Last NPPES UpdateSeptember 29, 2023
NPPES CertifiedSeptember 29, 2023
✔ NPI 1407384852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in WA · MD61414810
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
Also ListedInternal MedicineTaxonomy 207R00000X · License MT213556 (PA)
1100 9TH AVE, Seattle, WA 98101
Open in Google Maps ↗

Accepted Insurance

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

Nihaal Prashant Karnik 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 ID5294072054
PECOS Enrollment IDI20240923003877
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 5

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.

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
28 services28 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.
21 services21 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.
20 services17 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.
12 services11 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
11 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Geisinger-Community Medical Center

Acute Care Hospitals · Scranton, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390001
Location1822 Mulberry StreetScranton, PA 18510 · Lackawanna County
Emergency services Birthing friendly

Geisinger Medical Center

Acute Care Hospitals · Danville, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390006
Location100 North Academy AvenueDanville, PA 17822 · Montour County
Emergency services Birthing friendly

Geisinger Wyoming Valley Medical Center

Acute Care Hospitals · Wilkes Barre, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390270
Location1000 East Mountain BoulevardWilkes Barre, PA 18711 · Luzerne County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98101 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
$143.76 typical visit price
range $63.67 – $189.37
Typical copayment $35.94 (range $15.91 – $47.34)
Most-billed visit code 99204
Established Patient
$111.00 typical visit price
range $21.12 – $155.00
Typical copayment $27.75 (range $5.28 – $38.75)
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 20

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

JACLYN ANN SUBKOVIAK OT
Occupational Therapist
1100 9TH AVE
SEATTLE, WA 98101
King County (206) 341-0461
MARCIE G HUME PHARM.D.
Pharmacist
1100 9TH AVE, MS C3-PO
SEATTLE, WA 98101
King County (206) 223-6877
DR. VINAY GUPTA MD
Internal Medicine (Critical Care Medicine)
1100 9TH AVE
SEATTLE, WA 98101
King County (206) 223-6980
MARY JO BUKOVIC CCP
Contractor
1100 9TH AVE
SEATTLE, WA 98101
King County (206) 223-6600
PEGAH SAFAEIAN D.O.
Physical Medicine & Rehabilitation
1100 9TH AVE
SEATTLE, WA 98101
King County (206) 223-6600
MRS. GENEVIEVE HOUDET-COTE SLP
Speech-Language Pathologist
1100 9TH AVE, MS:H4-PMR
SEATTLE, WA 98101
King County (206) 341-0461
ROBERT DALE MCCLURE MD
Surgery
1100 9TH AVE
SEATTLE, WA 98101
King County (206) 223-6600
VIRGINIA MASON MEDICAL CENTER
Internal Medicine (Gastroenterology)
1100 9TH AVE
SEATTLE, WA 98101
King County (206) 223-6600

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 Nihaal Karnik's NPI number?

The NPI number for Nihaal Karnik is 1407384852. It was assigned to this individual provider in the NPPES registry on May 30, 2017.

Where is Nihaal Karnik located?

Nihaal Karnik practices at 1100 9th Ave, Seattle, WA 98101. The listed phone number is (206) 223-2319.

What is Nihaal Karnik's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Nihaal Karnik enrolled in Medicare?

Yes. Nihaal Karnik 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 Nihaal Karnik accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Nihaal Karnik 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 Nihaal Karnik affiliated with any hospitals?

According to CMS data, Nihaal Karnik is affiliated with Geisinger-Community Medical Center, Geisinger Medical Center and Geisinger Wyoming Valley Medical Center.

When was this NPI record last updated?

The NPPES record for Nihaal Karnik was last updated on September 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.