NIRANJAN SHRESTHA M.D., FAAFP
NPI 1508031758
Family Medicine in Centralia, IL

Q: What is Niranjan Shrestha's NPI number?

The NPI number for Niranjan Shrestha is 1508031758. It was assigned to this individual provider in the NPPES registry on April 29, 2008.

Q: What is Niranjan Shrestha's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Niranjan Shrestha was last updated on October 3, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.

Active since April 29, 2008PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

1050 M L KING DR STE 111, CENTRALIA, IL 62801(618) 436-5237(618) 436-5236 Get Directions Write a Review

NPPES record last updated: October 3, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Niranjan Shrestha M.d., Faafp NPPES

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

NIRANJAN SHRESTHA M.D., FAAFP (NPI 1508031758) is an individual family medicine provider in Centralia, Illinois, licensed in Illinois (036.122701) and active in the NPI registry since April 2008. He is enrolled in Medicare PECOS, is affiliated with Ssm Health St Mary's Hospital -centralia, and is a graduate of Other (2001).

NPPES Registry Identity

NPI1508031758

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameNIRANJAN SHRESTHACredential: M.D., FAAFP

Location Address1050 M L KING DR STE 111Centralia, IL 62801-3060

Mailing Address1050 M L King Dr Ste 111Centralia, IL 62801-3060 · (618) 436-5237 · Fax (618) 436-5236

Phone(618) 436-5237

Fax(618) 436-5236

Sole ProprietorNo

Medical School CMSOtherGraduated 2001

Enumeration DateApril 29, 2008

Last NPPES UpdateOctober 3, 2012

✔ NPI 1508031758 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in IL · 036.122701✔ Licensed in OH · 57009736

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.

1050 M L KING DR STE 111, Centralia, IL 62801

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, 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

Niranjan Shrestha M.d., Faafp 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 ID1759437924

PECOS Enrollment IDI20090914000592

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.

647 services218 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.

564 services178 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

92 services13 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

40 services14 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.

37 services37 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

21 services21 patients

Hospital Affiliations CMS Care Compare 3

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

Ssm Health St Mary's Hospital -Centralia

Acute Care Hospitals · Centralia, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140034

Location400 North Pleasant AvenueCentralia, IL 62801 · Marion County

Emergency services

Good Samaritan Regional Hlth Center

Acute Care Hospitals · Mount Vernon, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140046

Location1 Good Samaritan WayMount Vernon, IL 62864 · Jefferson County

Emergency services Birthing friendly

University Of Illinois Hospital And Clinics

Acute Care Hospitals · Chicago, IL

2/5 CMS rating

OwnershipGovernment - State

CMS Certification Number140150

Location1740 West Taylor St Suite 1400Chicago, IL 60612 · Cook County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62801 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

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.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

100

Improvement Activities

Cost

90.68

Reported Quality Measures

Advance Care Plan

100%268 patients5/55-star benchmark: 100%

Controlling High Blood Pressure

91%205 patients4/55-star benchmark: 98%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

8%154 patients4/55-star benchmark: 98%

Documentation of Current Medications in the Medical Record

100%3,650 patients5/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

100%605 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.

Referred Medical Equipment & Supplies CMS DME claims 47

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

10 suppliers75 claims184 services$6.05 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

8 suppliers24 claims33 services$1.05 avg. paid by Medicare

Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each A4385

DME-Orthotic Devices · category DF010N

3 suppliers12 claims400 services$4.91 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

2 suppliers13 claims13 services$38.24 avg. paid by Medicare

Tracheal suction catheter, any type other than closed system, each A4624

DME-Other DME · category DE000N

1 supplier12 claims1,080 services$2.38 avg. paid by Medicare

Oropharyngeal suction catheter, each A4628

DME-Other DME · category DE000N

1 supplier14 claims51 services$3.62 avg. paid by Medicare

Tracheostomy care kit for established tracheostomy A4629

DME-Orthotic Devices · category DF000N

1 supplier12 claims360 services$4.27 avg. paid by Medicare

Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing A6212

DME-Medical/Surgical Supplies · category DA023N

1 supplier25 claims352 services$8.87 avg. paid by Medicare

Canister, disposable, used with suction pump, each A7000

DME-Other DME · category DE000N

1 supplier14 claims14 services$7.05 avg. paid by Medicare

Tubing, used with suction pump, each A7002

DME-Other DME · category DE000N

1 supplier14 claims14 services$3.63 avg. paid by Medicare

Administration set, with small volume nonfiltered pneumatic nebulizer, disposable A7003

DME-Other DME · category DE000N

4 suppliers120 claims240 services$1.78 avg. paid by Medicare

Filter, disposable, used with aerosol compressor or ultrasonic generator A7013

DME-Other DME · category DE000N

1 supplier87 claims176 services$0.64 avg. paid by Medicare

Aerosol mask, used with dme nebulizer A7015

DME-Other DME · category DE000N

1 supplier95 claims96 services$1.35 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

5 suppliers17 claims17 services$103.68 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

4 suppliers24 claims36 services$41.69 avg. paid by Medicare

Cushion for use on nasal mask interface, replacement only, each A7032

DME-Other DME · category DE001N

1 supplier11 claims23 services$22.24 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

5 suppliers18 claims18 services$22.66 avg. paid by Medicare

Tubing used with positive airway pressure device A7037

DME-Other DME · category DE001N

4 suppliers11 claims11 services$19.39 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

4 suppliers32 claims92 services$2.62 avg. paid by Medicare

Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034

Other-Enteral and Parenteral · category OB006N

1 supplier94 claims2,851 services$4.07 avg. paid by Medicare

Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035

Other-Enteral and Parenteral · category OB006N

2 suppliers150 claims4,480 services$7.44 avg. paid by Medicare

Gastrostomy/jejunostomy tube, standard, any material, any type, each B4087

Other-Enteral and Parenteral · category OB006N

1 supplier75 claims76 services$28.45 avg. paid by Medicare

Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4150

Other-Enteral and Parenteral · category OB006N

2 suppliers44 claims17,075 services$0.45 avg. paid by Medicare

Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152

Other-Enteral and Parenteral · category OB006N

1 supplier202 claims92,342 services$0.32 avg. paid by Medicare

Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4154

Other-Enteral and Parenteral · category OB006N

1 supplier23 claims9,364 services$0.81 avg. paid by Medicare

Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit B4155

Other-Enteral and Parenteral · category OB006N

1 supplier105 claims4,372 services$0.76 avg. paid by Medicare

Walker, heavy duty, wheeled, rigid or folding, any type E0149

DME-Other DME · category DE000N

1 supplier11 claims11 services$7.93 avg. paid by Medicare

Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty E0181

DME-Other DME · category DE000N

1 supplier16 claims16 services$14.68 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

2 suppliers83 claims86 services$68.30 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

3 suppliers86 claims90 services$21.04 avg. paid by Medicare

Portable oxygen contents, gaseous, 1 month's supply = 1 unit E0443

DME-Oxygen and Supplies · category DC000N

2 suppliers28 claims33 services$47.98 avg. paid by Medicare

Humidifier, heated, used with positive airway pressure device E0562

DME-Other DME · category DE001N

1 supplier23 claims23 services$16.85 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

2 suppliers92 claims92 services$7.21 avg. paid by Medicare

Respiratory suction pump, home model, portable or stationary, electric E0600

DME-Other DME · category DE000N

1 supplier27 claims27 services$29.53 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

3 suppliers36 claims36 services$48.79 avg. paid by Medicare

Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) E0630

DME-Other DME · category DE000N

2 suppliers48 claims48 services$56.53 avg. paid by Medicare

Transport chair, adult size, patient weight capacity up to and including 300 pounds E1038

DME-Other DME · category DE000N

1 supplier20 claims20 services$12.36 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

7 suppliers215 claims219 services$110.33 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$29.79 avg. paid by Medicare

Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms J7605

DME-Drugs Administered Through DME · category DG006N

2 suppliers21 claims1,260 services$4.49 avg. paid by Medicare

Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms J7606

DME-Drugs Administered Through DME · category DG006N

5 suppliers36 claims2,130 services$6.43 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

6 suppliers24 claims4,370 services$0.03 avg. paid by Medicare

Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626

DME-Drugs Administered Through DME · category DG000N

8 suppliers57 claims3,690 services$0.82 avg. paid by Medicare

Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram J7677

DME-Drugs Administered Through DME · category DG006N

3 suppliers12 claims63,000 services$0.15 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

1 supplier18 claims18 services$29.18 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

4 suppliers86 claims89 services$192.33 avg. paid by Medicare

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

7 suppliers71 claims71 services$26.05 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Niranjan Shrestha's NPI number?

The NPI number for Niranjan Shrestha is 1508031758. It was assigned to this individual provider in the NPPES registry on April 29, 2008.

Where is Niranjan Shrestha located?

Niranjan Shrestha practices at 1050 M L King Dr Ste 111, Centralia, IL 62801. The listed phone number is (618) 436-5237.

What is Niranjan Shrestha's specialty?

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

Is Niranjan Shrestha enrolled in Medicare?

Yes. Niranjan 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.

What insurance does Niranjan Shrestha accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Niranjan 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.

Is Niranjan Shrestha affiliated with any hospitals?

According to CMS data, Niranjan Shrestha is affiliated with Ssm Health St Mary's Hospital -Centralia, Good Samaritan Regional Hlth Center and University Of Illinois Hospital And Clinics.

When was this NPI record last updated?

The NPPES record for Niranjan Shrestha was last updated on October 3, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.