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PRASHANTA KOIRALA M.D.
NPI 1437368180
Internal Medicine in Winchester, VA

Active since May 21, 2007PECOS EnrolledAccepts Medicare Assignment
190 CAMPUS BLVD STE 200, WINCHESTER, VA 22601(540) 662-6135(540) 662-5845 Get Directions Write a Review

NPPES record last updated: January 15, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 15, 2026, Jul 10, 2023, Mar 8, 2023 and 3 more (6 updates tracked since 2020).

About Prashanta Koirala M.d. NPPES

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

PRASHANTA KOIRALA M.D. (NPI 1437368180) is an individual internal medicine provider in Winchester, Virginia, licensed in Virginia (0101262674) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Winchester Medical Center, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1437368180
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NamePRASHANTA KOIRALACredential: M.D.
Location Address190 CAMPUS BLVD STE 200Winchester, VA 22601-2872
Mailing Address220 Campus Blvd Ste 100Winchester, VA 22601-2896 · (540) 536-5100 · Fax (540) 536-0235
Phone(540) 662-6135
Fax(540) 662-5845
Sole ProprietorYes
Medical School CMSOtherGraduated 2004
Enumeration DateMay 21, 2007
Last NPPES UpdateJanuary 15, 20266 updates tracked since enumeration
NPPES CertifiedJanuary 15, 2026
✔ NPI 1437368180 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in VA · 0101262674
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
190 CAMPUS BLVD STE 200, Winchester, VA 22601
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Other Identifiers 2

Medicaid2118668LA
Other4P436F600LA · Medicare Provider

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Highmark Blue Cross Blue Shield West Virginia.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

Prashanta Koirala M.d. 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 ID749473858
PECOS Enrollment IDI20180110000388
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.

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.
76 services52 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
51 services43 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
45 services44 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.
44 services42 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.
37 services37 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.
26 services22 patients

Hospital Affiliations CMS Care Compare 5

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

Winchester Medical Center

Acute Care Hospitals · Winchester, VA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490005
Location1840 Amherst StWinchester, VA 22601 · Winchester City County
Emergency services Birthing friendly

Warren Memorial Hospital

Acute Care Hospitals · Front Royal, VA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490033
Location351 Valley Health WayFront Royal, VA 22630 · Warren County
Emergency services

Shenandoah Memorial Hospital

Critical Access Hospitals · Woodstock, VA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number491305
Location759 South Main StreetWoodstock, VA 22664 · Shenandoah County
Emergency services

Berkeley Medical Center

Acute Care Hospitals · Martinsburg, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510008
Location2500 Hospital DriveMartinsburg, WV 25401 · Berkeley County
Emergency services Birthing friendly

Valley Health War Memorial Hospital

Critical Access Hospitals · Berkeley Springs, WV
OwnershipVoluntary non-profit - Private
CMS Certification Number511309
Location1 Healthy WayBerkeley Springs, WV 25411 · Morgan County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22601 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
$129.04 typical visit price
range $56.19 – $170.30
Typical copayment $32.26 (range $14.04 – $42.57)
Most-billed visit code 99204
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
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…
99%327 patients4/55-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.

Referred Medical Equipment & Supplies CMS DME claims

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

Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
1 supplier16 claims16 services$795.30 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 2

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

SHERRY K SCHOTT MD
Internal Medicine
190 CAMPUS BLVD STE 200
WINCHESTER, VA 22601
Winchester City (540) 662-6135
RUMA DAHAL MD
Family Medicine (Adult Medicine)
190 CAMPUS BLVD STE 200
WINCHESTER, VA 22601
Winchester City (540) 662-6135

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 Prashanta Koirala's NPI number?

The NPI number for Prashanta Koirala is 1437368180. It was assigned to this individual provider in the NPPES registry on May 21, 2007.

Where is Prashanta Koirala located?

Prashanta Koirala practices at 190 Campus Blvd Ste 200, Winchester, VA 22601. The listed phone number is (540) 662-6135.

What is Prashanta Koirala's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Prashanta Koirala enrolled in Medicare?

Yes. Prashanta Koirala 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 Prashanta Koirala accept?

Health plans from CareSource and Highmark Blue Cross Blue Shield West Virginia list Prashanta Koirala 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 Prashanta Koirala affiliated with any hospitals?

According to CMS data, Prashanta Koirala is affiliated with Winchester Medical Center, Warren Memorial Hospital, Shenandoah Memorial Hospital, Berkeley Medical Center and Valley Health War Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Prashanta Koirala was last updated on January 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.