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PRAJESH MANI GHIMIRE M.D.
NPI 1821300401
Family Medicine in Saratoga Springs, NY

Active since July 12, 2010PECOS EnrolledAccepts Medicare Assignment
2 TOMMY LUTHER DR, SARATOGA SPRINGS, NY 12866(518) 581-0892 Get Directions Write a Review

NPPES record last updated: August 21, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Prajesh Mani Ghimire M.d. NPPES

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

PRAJESH MANI GHIMIRE M.D. (NPI 1821300401) is an individual family medicine provider in Saratoga Springs, New York, licensed in North Carolina (2011-01067) and active in the NPI registry since July 2010. He is enrolled in Medicare PECOS, is affiliated with Albany Medical Center Hospital, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1821300401
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NamePRAJESH MANI GHIMIRECredential: M.D.
Location Address2 TOMMY LUTHER DRSaratoga Springs, NY 12866-6054
Mailing Address113 Deanna CtNiskayuna, NY 12309-1333 · (518) 330-2843
Phone(518) 581-0892
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateJuly 12, 2010
Last NPPES UpdateAugust 21, 2023
NPPES CertifiedAugust 21, 2023
✔ NPI 1821300401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NC · 2011-01067
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2 TOMMY LUTHER DR, Saratoga Springs, NY 12866
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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

Prajesh Mani Ghimire 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 ID5193987949
PECOS Enrollment IDI20120503000072
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.
475 services183 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.
459 services213 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.
188 services187 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.
152 services149 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.
14 services14 patients

Hospital Affiliations CMS Care Compare 5

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

Albany Medical Center Hospital

Acute Care Hospitals · Albany, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330013
Location43 New Scotland Avenue, Mail Code 34Albany, NY 12208 · Albany County
Emergency services Birthing friendly

St Peter's Hospital

Acute Care Hospitals · Albany, NY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330057
Location315 South Manning BoulevardAlbany, NY 12208 · Albany County
Emergency services Birthing friendly

Aurelia Osborn Fox Memorial Hospital

Acute Care Hospitals · Oneonta, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330085
LocationOne Norton AvenueOneonta, NY 13820 · Otsego County
Emergency services

Columbia Memorial Hospital

Acute Care Hospitals · Hudson, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330094
Location71 Prospect AvenueHudson, NY 12534 · Columbia County
Emergency services

Samaritan Hospital Of Troy, New York

Acute Care Hospitals · Troy, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330180
Location2215 Burdett AvenueTroy, NY 12180 · Rensselaer County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 12866 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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 2

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers14 claims14 services$17.51 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers15 claims15 services$88.30 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Prajesh Ghimire's NPI number?

The NPI number for Prajesh Ghimire is 1821300401. It was assigned to this individual provider in the NPPES registry on July 12, 2010.

Where is Prajesh Ghimire located?

Prajesh Ghimire practices at 2 Tommy Luther Dr, Saratoga Springs, NY 12866. The listed phone number is (518) 581-0892.

What is Prajesh Ghimire's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Prajesh Ghimire enrolled in Medicare?

Yes. Prajesh Ghimire 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.

Is Prajesh Ghimire affiliated with any hospitals?

According to CMS data, Prajesh Ghimire is affiliated with Albany Medical Center Hospital, St Peter's Hospital, Aurelia Osborn Fox Memorial Hospital, Columbia Memorial Hospital and Samaritan Hospital Of Troy, New York.

When was this NPI record last updated?

The NPPES record for Prajesh Ghimire was last updated on August 21, 2023. 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.