DR. ROSHAN MAINALI M.D.
NPI 1700990629
Internal Medicine - Nephrology in Lewistown, PA

Active since August 18, 2006PECOS EnrolledAccepts Medicare Assignment
21 GEISINGER LN, LEWISTOWN, PA 17044(717) 242-4200(717) 242-4212 Get Directions Write a Review

NPPES record last updated: August 6, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Roshan Mainali M.d. NPPES

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

DR. ROSHAN MAINALI M.D. (NPI 1700990629) is an individual nephrology provider in Lewistown, Pennsylvania, licensed in Pennsylvania (MD429481) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Geisinger Medical Center, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1700990629
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameDR. ROSHAN MAINALICredential: M.D.
Location Address21 GEISINGER LNLewistown, PA 17044-3400
Mailing Address100 N Academy AveDanville, PA 17822-3034 · (570) 271-6144 · Fax (570) 271-6578
Fax(717) 242-4212
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateAugust 18, 2006
Last NPPES UpdateAugust 6, 2020
NPPES CertifiedAugust 6, 2020
NPI 1700990629 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License Licensed in PA · MD429481
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Also ListedInternal MedicineTaxonomy 207R00000X · License PAMD429481 (PA)
21 GEISINGER LN, Lewistown, PA 17044

Accepted 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

Dr. Roshan Mainali 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 ID9537168067
PECOS Enrollment IDI20061212000123
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 9

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.
230 services99 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.
178 services145 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.
77 services70 patients
Hemodialysis procedure with physician evaluation 90935
Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.
35 services20 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.
28 services27 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.
23 services23 patients

Hospital Affiliations CMS Care Compare 3

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

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-Lewistown Hospital

Acute Care Hospitals · Lewistown, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390048
Location400 Highland AvenueLewistown, PA 17044 · Mifflin County
Emergency services Birthing friendly

Mount Nittany Medical Center

Acute Care Hospitals · State College, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390268
Location1800 East Park AveState College, PA 16803 · Centre County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 17044 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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 4

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

Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers25 claims810 services$0.26 avg. paid by Medicare
Mycophenolate mofetil, oral, 250 mg J7517
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier12 claims1,440 services$0.16 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
3 suppliers22 claims22 services$17.20 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512
Treatment-Chemotherapy · category RH012N
3 suppliers15 claims15 services$10.34 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 20

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

Pharmacy (Community/Retail Pharmacy)
21 GEISINGER LN
LEWISTOWN, PA 17044
Dermatology
21 GEISINGER LN
LEWISTOWN, PA 17044
Physician Assistant
21 GEISINGER LN
LEWISTOWN, PA 17044
Physician Assistant
21 GEISINGER LN
LEWISTOWN, PA 17044
Physician Assistant
21 GEISINGER LN
LEWISTOWN, PA 17044
Physician Assistant
21 GEISINGER LN
LEWISTOWN, PA 17044
Dietitian, Registered
21 GEISINGER LN
LEWISTOWN, PA 17044
Physician Assistant
21 GEISINGER LN
LEWISTOWN, PA 17044

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 Roshan Mainali's NPI number?

The NPI number for Roshan Mainali is 1700990629. It was assigned to this individual provider in the NPPES registry on August 18, 2006.

Where is Roshan Mainali located?

Roshan Mainali practices at 21 Geisinger Ln, Lewistown, PA 17044. The listed phone number is (717) 242-4200.

What is Roshan Mainali's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Roshan Mainali enrolled in Medicare?

Yes. Roshan Mainali 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 Roshan Mainali accept?

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

According to CMS data, Roshan Mainali is affiliated with Geisinger Medical Center, Geisinger-Lewistown Hospital and Mount Nittany Medical Center.

When was this NPI record last updated?

The NPPES record for Roshan Mainali was last updated on August 6, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.