ABBAL KOIRALA M.D.
NPI 1730449653
Internal Medicine - Nephrology in Baltimore, MD

Q: What is Abbal Koirala's NPI number?

The NPI number for Abbal Koirala is 1730449653. It was assigned to this individual provider in the NPPES registry on May 24, 2012.

Q: What is Abbal Koirala's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Abbal Koirala was last updated on July 24, 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.

Active since May 24, 2012PECOS Enrolled

93.09/100

CMS Quality Rating

4940 EASTERN AVE, BALTIMORE, MD 21224(410) 550-5568(410) 550-0470 Get Directions Write a Review

NPPES record last updated: July 24, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 24, 2024, May 4, 2018 (2 updates tracked since 2018).

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About Abbal Koirala M.d. NPPES

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

ABBAL KOIRALA M.D. (NPI 1730449653) is an individual nephrology provider in Baltimore, Maryland, licensed in Maryland (D0100321) and active in the NPI registry since May 2012. He is enrolled in Medicare PECOS, is affiliated with Johns Hopkins Hospital, The, and maintains a secondary practice location in Seattle.

NPPES Registry Identity

NPI1730449653

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameABBAL KOIRALACredential: M.D.

Location Address4940 EASTERN AVEBaltimore, MD 21224-2735

Mailing Address6201 Greenleigh AveMiddle River, MD 21220-2004 · (410) 933-6423 · Fax (410) 500-4266

Phone(410) 550-5568

Fax(410) 550-0470

Sole ProprietorNo

Medical School CMSOtherGraduated 2008

Enumeration DateMay 24, 2012

Last NPPES UpdateJuly 24, 20242 updates tracked since enumeration

NPPES CertifiedJuly 24, 2024

✔ NPI 1730449653 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

Licenses✔ Licensed in MD · D0100321✔ Licensed in WA · MD60641276

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.

4940 EASTERN AVE, Baltimore, MD 21224

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Secondary Practice Location 1

Location 11959 NE Pacific StSeattle, WA 98195-3328 · Phone (206) 598-2844

Other Identifiers 1

Medicaid1730449653WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Abbal Koirala M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4789800921

PECOS Enrollment IDI20240806004478

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.

160 services90 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.

91 services47 patients

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.

75 services60 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.

41 services40 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 services36 patients

Dialysis services, 2-3 physician visits per month (20 years or older) 90961

Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.

34 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Johns Hopkins Hospital, The

Acute Care Hospitals · Baltimore, MD

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number210009

Location600 North Wolfe StreetBaltimore, MD 21287 · Baltimore City County

Emergency services Birthing friendly

Johns Hopkins Bayview Medical Center

Acute Care Hospitals · Baltimore, MD

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number210029

Location4940 Eastern AvenueBaltimore, MD 21224 · Baltimore City County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21224 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

$139.05 typical visit price

range $60.73 – $183.44

Typical copayment $34.76 (range $15.18 – $45.86)

Most-billed visit code 99204

Established Patient

$106.59 typical visit price

range $19.60 – $149.17

Typical copayment $26.64 (range $4.90 – $37.29)

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.

93.09/100

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

Scored through an Alternative Payment Model

Quality

73.95

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 8

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

3 suppliers15 claims39 services$4.90 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

3 suppliers12 claims16 services$0.84 avg. paid by Medicare

Tacrolimus, immediate release, oral, 1 mg J7507

Treatment-Treatment - Miscellaneous · category RX029N

3 suppliers49 claims4,002 services$0.31 avg. paid by Medicare

Prednisone, immediate release or delayed release, oral, 1 mg J7512

Treatment-Treatment - Miscellaneous · category RX029N

2 suppliers30 claims4,455 services$0.01 avg. paid by Medicare

Mycophenolic acid, oral, 180 mg J7518

Treatment-Treatment - Miscellaneous · category RX029N

3 suppliers57 claims5,326 services$0.62 avg. paid by Medicare

Sirolimus, oral, 1 mg J7520

Treatment-Treatment - Miscellaneous · category RX029N

1 supplier11 claims533 services$2.57 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.

DR. SUSRUTHA KOTWAL MD

Internal Medicine

4940 EASTERN AVE, MFL BLDG, WEST TOWER, 6TH FLOOR
BALTIMORE, MD 21224

Baltimore City (410) 550-5018

DR. SAMANTHA A WOLFE MD

Otolaryngology