DR. SHANKAR PRASAD GHIMIRE M.D.
NPI 1851693378
Family Medicine in Fremont, CA

Active since December 04, 2010PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
734 MOWRY AVE, FREMONT, CA 94536(510) 742-6274 Get Directions Write a Review

NPPES record last updated: July 15, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Shankar Prasad Ghimire M.d. NPPES

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

DR. SHANKAR PRASAD GHIMIRE M.D. (NPI 1851693378) is an individual family medicine provider in Fremont, California, licensed in California (A114532) and active in the NPI registry since December 2010. He is enrolled in Medicare PECOS and is a graduate of Other (2003).

NPPES Registry Identity

NPI1851693378
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. SHANKAR PRASAD GHIMIRECredential: M.D.
Location Address734 MOWRY AVEFremont, CA 94536-4115
Mailing Address734 Mowry AveFremont, CA 94536-4115 · (510) 742-6274
Sole ProprietorYes
Medical School CMSOtherGraduated 2003
Enumeration DateDecember 4, 2010
Last NPPES UpdateJuly 15, 2011
NPI 1851693378 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in CA · A114532
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.
734 MOWRY AVE, Fremont, CA 94536

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. Shankar Prasad 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 ID1153508650
PECOS Enrollment IDI20110610000018
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 7

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 nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
3,186 services608 patients
Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306
An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
412 services331 patients
Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308
A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.
386 services143 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
92 services89 patients
Nursing facility discharge management, more than 30 minutes 99316
Nursing facility discharge management over 30 minutes is a comprehensive process where a healthcare team prepares you for leaving the facility. It involves creating a tailored plan, coordinating care, and ensuring a smooth transition to your next care setting.
84 services81 patients
Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310
A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
53 services52 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94536 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
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$119.48 typical visit price
range $23.44 – $166.46
Typical copayment $29.87 (range $5.86 – $41.61)
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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

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.

Lightweight wheelchair K0003
DME-Wheelchairs · category DD000N
3 suppliers18 claims18 services$24.51 avg. paid by Medicare
Elevating leg rests, pair (for use with capped rental wheelchair base) K0195
DME-Wheelchairs · category DD021N
2 suppliers21 claims21 services$8.95 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 11

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

Internal Medicine (Gastroenterology)
734 MOWRY AVE
FREMONT, CA 94536
Internal Medicine (Rheumatology)
734 MOWRY AVE
FREMONT, CA 94536
Internal Medicine
734 MOWRY AVE
FREMONT, CA 94536
Clinic/Center (Multi-Specialty)
734 MOWRY AVE
FREMONT, CA 94536
Physician Assistant
734 MOWRY AVE, FREMONT MEDICAL GROUP
FREMONT, CA 94536
Pharmacist
734 MOWRY AVE
FREMONT, CA 94536
Nurse Practitioner
734 MOWRY AVE
FREMONT, CA 94536
Internal Medicine (Gastroenterology)
734 MOWRY AVE
FREMONT, CA 94536

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 Shankar Ghimire's NPI number?

The NPI number for Shankar Ghimire is 1851693378. It was assigned to this individual provider in the NPPES registry on December 4, 2010.

Where is Shankar Ghimire located?

Shankar Ghimire practices at 734 Mowry Ave, Fremont, CA 94536. The listed phone number is (510) 742-6274.

What is Shankar Ghimire's specialty?

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

Is Shankar Ghimire enrolled in Medicare?

Yes. Shankar 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.

When was this NPI record last updated?

The NPPES record for Shankar Ghimire was last updated on July 15, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.