Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

PRAKASH ADHIKARI MD
NPI 1811559750
Internal Medicine in Athens, GA

Q: What is Prakash Adhikari's NPI number?

The NPI number for Prakash Adhikari is 1811559750. It was assigned to this individual provider in the NPPES registry on July 1, 2019.

Q: What is Prakash Adhikari's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Prakash Adhikari was last updated on July 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 39 days 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 01, 2019PECOS EnrolledAccepts Medicare Assignment

81.19/100

CMS Quality Rating

1270 PRINCE AVE STE 201, ATHENS, GA 30606(706) 475-7055 Get Directions Write a Review

NPPES record last updated: July 1, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Prakash Adhikari Md NPPES

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

PRAKASH ADHIKARI MD (NPI 1811559750) is an individual internal medicine provider in Athens, Georgia, licensed in Georgia (11622) and active in the NPI registry since July 2019. He is enrolled in Medicare PECOS, is affiliated with Reading Hospital, and maintains a secondary practice location in West Reading.

NPPES Registry Identity

NPI1811559750

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NamePRAKASH ADHIKARICredential: MD

Location Address1270 PRINCE AVE STE 201Athens, GA 30606-2789

Mailing AddressPo Box 13579Reading, PA 19612-3579 · (846) 281-3244

Phone(706) 475-7055

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateJuly 1, 2019

Last NPPES UpdateJuly 1, 2026

NPPES CertifiedJuly 1, 2026

✔ NPI 1811559750 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in GA · 11622✔ Licensed in PA · MD477640

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

1270 PRINCE AVE STE 201, Athens, GA 30606

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Secondary Practice Location 1

Location 1420 S 5th AveWest Reading, PA 19611-2143 · Phone (484) 628-5455

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

Prakash Adhikari Md 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 ID5193123016

PECOS Enrollment IDI20220601000660

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 5

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.

331 services173 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.

224 services127 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.

111 services109 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

81 services79 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.

16 services16 patients

Hospital Affiliations CMS Care Compare

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

Reading Hospital

Acute Care Hospitals · West Reading, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390044

Location420 S 5th AvenueWest Reading, PA 19611 · Berks County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30606 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

$124.10 typical visit price

range $53.31 – $164.04

Typical copayment $31.02 (range $13.32 – $41.01)

Most-billed visit code 99204

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

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.

81.19/100

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

Scored as part of a group practice

Quality

74.56

Promoting Interoperability

Improvement Activities

Cost

65.23

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.

OLUWAMISIMI MARY ABIB MD

Student in an Organized Health Care Education/Training Program