DR. PRAJWAL DHAKAL MBBS
NPI 1578946406
Internal Medicine - Hematology in Iowa City, IA

Q: What is Prajwal Dhakal's NPI number?

The NPI number for Prajwal Dhakal is 1578946406. It was assigned to this individual provider in the NPPES registry on July 9, 2015.

Q: What is Prajwal Dhakal's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology, with taxonomy code 207RH0000X.

Q: When was this NPI record last updated?

The NPPES record for Prajwal Dhakal was last updated on September 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 July 09, 2015PECOS EnrolledAccepts Medicare Assignment

200 HAWKINS DR, IOWA CITY, IA 52242(319) 356-2148(319) 353-8383 Get Directions Write a Review

NPPES record last updated: September 13, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Prajwal Dhakal Mbbs NPPES

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

DR. PRAJWAL DHAKAL MBBS (NPI 1578946406) is an individual hematology provider in Iowa City, Iowa, licensed in Iowa (MD-48076) and active in the NPI registry since July 2015. He is enrolled in Medicare PECOS, is affiliated with Genesis Hlth System Dba Genesis Mdl Ctr-illini, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1578946406

Entity TypeIndividualMale

Primary Taxonomy207RH0000X

Provider Legal NameDR. PRAJWAL DHAKALCredential: MBBS

Location Address200 HAWKINS DRIowa City, IA 52242-1009

Mailing Address788 Service Rd, Room B301East Lansing, MI 48824-7013 · (517) 353-5100 · Fax (517) 432-2759

Phone(319) 356-2148

Fax(319) 353-8383

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateJuly 9, 2015

Last NPPES UpdateSeptember 13, 2021

NPPES CertifiedSeptember 13, 2021

✔ NPI 1578946406 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · HematologyAllopathic & Osteopathic Physicians

Taxonomy Code207RH0000X

License✔ Licensed in IA · MD-48076

Definition

An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, clotting disorders, sickle cell disease, hemophilia, leukemia and lymphoma.

Also ListedInternal MedicineTaxonomy 207R00000X · License MD-48076 (IA), 4301107316 (MI)

200 HAWKINS DR, Iowa City, IA 52242

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan, 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 and accepts Medicare assignment

Dr. Prajwal Dhakal Mbbs 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 ID4183974330

PECOS Enrollment IDI20210811001246

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 Reassignment

Medicare enrollment records show Prajwal Dhakal reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

State University Of Iowa

Same address

Dentist

200 HAWKINS DRIVE, 51300 POMERANTZ FAMILY PAVILION
Iowa City, IA 52242

Reassigned Medicare billing, Iowa enrollment
2,190 clinicians in this Medicare group

NPI 1114905387 (319) 356-2743

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 7

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 high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

194 services58 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.

140 services36 patients

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.

46 services20 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.

25 services14 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.

21 services17 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

17 services17 patients

Hospital Affiliations CMS Care Compare 5

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

Genesis Hlth System Dba Genesis Mdl Ctr-Illini

Acute Care Hospitals · Silvis, IL

2/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number140275

Location801 Illini DrSilvis, IL 61282 · Rock Island County

Emergency services Birthing friendly

Trinity Muscatine

Acute Care Hospitals · Muscatine, IA

OwnershipVoluntary non-profit - Private

CMS Certification Number160013

Location1518 Mulberry AvenueMuscatine, IA 52761 · Muscatine County

Emergency services

Genesis Medical Center-Davenport

Acute Care Hospitals · Davenport, IA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number160033

Location1227 East Rusholme StreetDavenport, IA 52803 · Scott County

Emergency services Birthing friendly

University Of Iowa Hospital & Clinics

Acute Care Hospitals · Iowa City, IA

3/5 CMS rating

OwnershipGovernment - State

CMS Certification Number160058

Location200 Hawkins DriveIowa City, IA 52242 · Johnson County

Emergency services Birthing friendly

Regional Medical Center

Critical Access Hospitals · Manchester, IA

OwnershipGovernment - Local

CMS Certification Number161343

Location709 W Main StreetManchester, IA 52057 · Delaware County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 52242 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

$161.40 typical visit price

range $52.96 – $161.40

Typical copayment $40.35 (range $13.24 – $40.35)

Most-billed visit code 99205

Established Patient

$94.05 typical visit price

range $16.91 – $131.98

Typical copayment $23.51 (range $4.22 – $32.99)

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.

SANGIL LEE M.D.

Emergency Medicine

200 HAWKINS DR
IOWA CITY, IA 52242

Johnson County (319) 356-2233

RAMI G. EL ABIAD M.D.

Internal Medicine (Gastroenterology)

200 HAWKINS DR
IOWA CITY, IA 52242

Johnson County (319) 356-4901

GRERK SUTAMTEWAGUL MD

Internal Medicine (Hematology & Oncology)

200 HAWKINS DR, DEPT OF INTERNAL MEDICINE
IOWA CITY, IA 52242

Johnson County (319) 356-1616

DR. KALEB TANNER VEIT D.O.

Internal Medicine (Critical Care Medicine)

200 HAWKINS DR
IOWA CITY, IA 52242

Johnson County (319) 356-2320

OMAR JABER M.D

Chronic Disease Hospital

200 HAWKINS DR
IOWA CITY, IA 52242

Johnson County (319) 471-8958

JENNIFER MANCUSO MS, CGC

Genetic Counselor, MS

200 HAWKINS DR, 31663 PFP
IOWA CITY, IA 52242

Johnson County (319) 384-7983

ASHLEY KAISER M.D.

Obstetrics & Gynecology

200 HAWKINS DR, DEPT OF OBGYN
IOWA CITY, IA 52242

Johnson County (319) 356-2294

MRS. NANCY JANE MILLICE

Health Educator

200 HAWKINS DR, 0733 JPP
IOWA CITY, IA 52242

Johnson County (319) 356-3825

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 Prajwal Dhakal's NPI number?

The NPI number for Prajwal Dhakal is 1578946406. It was assigned to this individual provider in the NPPES registry on July 9, 2015.

Where is Prajwal Dhakal located?

Prajwal Dhakal practices at 200 Hawkins Dr, Iowa City, IA 52242. The listed phone number is (319) 356-2148.

What is Prajwal Dhakal's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology, with taxonomy code 207RH0000X.

Is Prajwal Dhakal enrolled in Medicare?

Yes. Prajwal Dhakal 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.

Which organization bills Medicare for Prajwal Dhakal's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Prajwal Dhakal reassigns Medicare benefits to State University Of Iowa (Iowa City, IA). The 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 Prajwal Dhakal's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Prajwal Dhakal accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and Oscar Insurance Company and 2 other insurers list Prajwal Dhakal 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 Prajwal Dhakal affiliated with any hospitals?

According to CMS data, Prajwal Dhakal is affiliated with Genesis Hlth System Dba Genesis Mdl Ctr-Illini, Trinity Muscatine, Genesis Medical Center-Davenport, University Of Iowa Hospital & Clinics and Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Prajwal Dhakal was last updated on September 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.