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DR. PRAKASH TAUJALE SHRESTHA M.D.
NPI 1427045392
Family Medicine in Dowagiac, MI

Active since October 05, 2005PECOS Enrolled
520 MAIN ST, DOWAGIAC, MI 49047(269) 390-0536 Get Directions Write a Review

NPPES record last updated: June 12, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 12, 2024, Aug 26, 2019, Sep 29, 2016 (3 updates tracked since 2016).

About Dr. Prakash Taujale Shrestha M.d. NPPES

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

DR. PRAKASH TAUJALE SHRESTHA M.D. (NPI 1427045392) is an individual family medicine provider in Dowagiac, Michigan, licensed in Michigan (4301110156) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1427045392
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. PRAKASH TAUJALE SHRESTHACredential: M.D.
Location Address520 MAIN STDowagiac, MI 49047-1762
Mailing Address520 Main StDowagiac, MI 49047-1762 · (269) 390-0536
Phone(269) 390-0536
Sole ProprietorNo
Enumeration DateOctober 5, 2005
Last NPPES UpdateJune 12, 20243 updates tracked since enumeration
NPPES CertifiedJune 12, 2024
✔ NPI 1427045392 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in MI · 4301110156✔ Licensed in SD · 5253
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
520 MAIN ST, Dowagiac, MI 49047
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Secondary Practice Locations 2

Location 1102 Major Allen DrMartin, SD 57551 · Phone (605) 685-6868
Location 24 Longmeadow Village DrNiles, MI 49120 · Phone (269) 684-6000 · Fax (269) 684-1388

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Prakash Taujale Shrestha M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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

3

Medicare enrollment records show Prakash Shrestha reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lakeland Medical Practices
13 mi
Audiologist
42 N SAINT JOSEPH AVE STE 300
Niles, MI 49120
  • Reassigned Medicare billing, Michigan enrollment
  • 724 clinicians in this Medicare group
NPI 1134898505 (269) 687-2910
Lakeland Community Hospital Watervliet
15 mi
Rural Health
2002 S 11TH ST
Niles, MI 49120
  • Reassigned Medicare billing, Michigan enrollment
  • 107 clinicians in this Medicare group
NPI 1538592753 (269) 687-0200
Intercare Community Health Network
19 mi
Federally Qualified Health Center (FQHC)
1485 M 139
Benton Harbor, MI 49022
  • Reassigned Medicare billing, Michigan enrollment
  • 101 clinicians in this Medicare group
NPI 1902235328 (269) 926-2595

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 8

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.
292 services181 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
84 services84 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.
35 services31 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
33 services29 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
23 services23 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
21 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49047 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.09 – $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.

Referred Medical Equipment & Supplies CMS DME claims 5

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
8 suppliers29 claims62 services$5.39 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
2 suppliers13 claims13 services$5.19 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$75.57 avg. paid by Medicare
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613
DME-Drugs Administered Through DME · category DG006N
1 supplier12 claims1,364 services$0.03 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
2 suppliers15 claims15 services$167.59 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 18

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

ALICIA JEAN LANE MSN, RN, FNP-C
Nurse Practitioner (Family)
520 MAIN ST
DOWAGIAC, MI 49047
Cass County (269) 783-3052
LISA MARIE SMITH PA
Physician Assistant
520 MAIN ST
DOWAGIAC, MI 49047
Cass County (269) 783-3052
LAKELAND COMMUNITY HOSPITAL WATERVLIET
Clinic/Center (Rural Health)
520 MAIN ST
DOWAGIAC, MI 49047
Cass County (269) 390-0536
CHRISTOPHER ALAN STALEY JR.
Physician Assistant (Medical)
520 MAIN ST
DOWAGIAC, MI 49047
Cass County (269) 783-3052
MS. CYNTHIA ZACHARY RDH
Dental Hygienist
520 MAIN ST, SUITE B
DOWAGIAC, MI 49047
Cass County (269) 782-0064
KARLEE RIFE
Dental Hygienist
520 MAIN ST, SUITE B
DOWAGIAC, MI 49047
Cass County (269) 782-0064
ERICA ROGERS NP-C
Nurse Practitioner (Family)
520 MAIN ST
DOWAGIAC, MI 49047
Cass County (269) 783-3052
SANGEETA PAL MD
Internal Medicine (Nephrology)
520 MAIN ST
DOWAGIAC, MI 49047
Cass County (269) 783-3052

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 1427045392. It was assigned to this individual provider in the NPPES registry on October 5, 2005.

Where is Prakash Shrestha located?

Prakash Shrestha practices at 520 Main St, Dowagiac, MI 49047. The listed phone number is (269) 390-0536.

What is Prakash Shrestha's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Prakash Shrestha enrolled in Medicare?

Yes. Prakash Shrestha is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Prakash Shrestha's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Prakash Shrestha reassigns Medicare benefits to 3 organizations: Lakeland Medical Practices (Niles, MI), Lakeland Community Hospital Watervliet (Niles, MI) and Intercare Community Health Network (Benton Harbor, MI). 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 Prakash Shrestha's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Prakash Shrestha accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 1 other insurer list Prakash Shrestha 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.

When was this NPI record last updated?

The NPPES record for Prakash Shrestha was last updated on June 12, 2024. 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.