AJAY KOIRALA M.D.
NPI 1730532656
Internal Medicine in Lewes, DE
About Ajay Koirala M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AJAY KOIRALA M.D. (NPI 1730532656) is an individual internal medicine provider in Lewes, Delaware, licensed in Delaware (C1-0027902) and active in the NPI registry since July 2016. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2011).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 2
Accepted 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
Ajay 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.
Medicare Billing Reassignments
4Medicare enrollment records show Ajay Koirala reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Lewes, DE 19958
- Reassigned Medicare billing, Delaware enrollment
- 382 clinicians in this Medicare group
Philadelphia, PA 19118
- Reassigned Medicare billing, Pennsylvania enrollment
- 1,473 clinicians in this Medicare group
Phoenixville, PA 19460
- Reassigned Medicare billing, Pennsylvania enrollment
- 529 clinicians in this Medicare group
Pottstown, PA 19465
- Reassigned Medicare billing, Pennsylvania enrollment
- 474 clinicians in this Medicare group
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 3
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 19958 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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.
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 Ajay Koirala's NPI number?
The NPI number for Ajay Koirala is 1730532656. It was assigned to this individual provider in the NPPES registry on July 15, 2016.
Where is Ajay Koirala located?
Ajay Koirala practices at 424 Savannah Rd, Lewes, DE 19958. The listed phone number is (302) 645-3525.
What is Ajay Koirala's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Ajay Koirala enrolled in Medicare?
Yes. Ajay 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.
Which organizations bill Medicare for Ajay Koirala's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Ajay Koirala reassigns Medicare benefits to 4 organizations: Beebe Physician Network, Inc. (Lewes, DE), Tower Health Medical Group (Philadelphia, PA), Phoenixville Clinic Company LLC (Phoenixville, PA) and Pottstown Clinic Company LLC (Pottstown, PA). Each 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 Ajay Koirala's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Ajay Koirala accept?
Health plans from AmeriHealth Caritas Next and Highmark Blue Cross Blue Shield Delaware list Ajay 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.
When was this NPI record last updated?
The NPPES record for Ajay Koirala was last updated on April 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Ajay Koirala, M.D. · NPI 1730532656
Internal Medicine physician in Lewes, Delaware. Individual provider, active in the CMS NPPES registry since July 15, 2016.
## Identity
- **NPI:** 1730532656 (Entity type: Individual)
- **Enumerated:** July 15, 2016
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** C1-0027902 (Delaware)
- **Sole proprietor:** No
## Practice location
- **Address:** 424 SAVANNAH RD, Lewes, DE 19958-1462
- **Phone:** (302) 645-3525 · **Fax:** (302) 645-3513
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Beebe Physician Network, Inc. (NPI 1730133992, Lewes, DE); Tower Health Medical Group (NPI 1306476924, Philadelphia, PA); Phoenixville Clinic Company LLC (NPI 1275173957, Phoenixville, PA); Pottstown Clinic Company LLC (NPI 1649341934, Pottstown, PA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2011
## Record status
- **NPPES last updated:** April 24, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1730532656) · Data from the CMS NPPES public registry.