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SUSHIL GHIMIRE M.D.
NPI 1912314840
Internal Medicine - Hematology & Oncology in Camden, NJ

Active since July 11, 2014PECOS EnrolledAccepts Medicare Assignment
81.71/100
CMS Quality Rating
2 COOPER PLZ, CAMDEN, NJ 08103(855) 632-2667 Get Directions Write a Review

NPPES record last updated: August 18, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 18, 2021, Jul 7, 2017 (2 updates tracked since 2017).

About Sushil Ghimire M.d. NPPES

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

SUSHIL GHIMIRE M.D. (NPI 1912314840) is an individual hematology & oncology provider in Camden, New Jersey, licensed in New Jersey (25MA11121700) and active in the NPI registry since July 2014. He is enrolled in Medicare PECOS, is affiliated with Cooper University Hospital, and maintains a secondary practice location in West Reading.

NPPES Registry Identity

NPI1912314840
Entity TypeIndividualMale
Primary Taxonomy207RH0003X
Provider Legal NameSUSHIL GHIMIRECredential: M.D.
Location Address2 COOPER PLZCamden, NJ 08103-1461
Mailing Address1 Federal St # 200Camden, NJ 08103-1088 · (856) 356-4924
Phone(855) 632-2667
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateJuly 11, 2014
Last NPPES UpdateAugust 18, 20212 updates tracked since enumeration
NPPES CertifiedAugust 18, 2021
✔ NPI 1912314840 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0003X
License✔ Licensed in NJ · 25MA11121700
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Also ListedInternal MedicineTaxonomy 207R00000X · License MD461645 (PA), MT206484 (PA)
2 COOPER PLZ, Camden, NJ 08103
Open in Google Maps ↗

Secondary Practice Location 1

Location 16th Avenue & Spruce StreetWest Reading, PA 19611 · Phone (484) 628-8640 · Fax (484) 628-9003

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

Sushil 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 ID9032400114
PECOS Enrollment IDI20210909000063
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.

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.
234 services123 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.
109 services49 patients
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.
47 services26 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
29 services28 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.
20 services19 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
19 services19 patients

Hospital Affiliations CMS Care Compare 2

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

Cooper University Hospital

Acute Care Hospitals · Camden, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310014
Location1 Cooper PlazaCamden, NJ 08103 · Camden County
Emergency services Birthing friendly

Virtua Mount Holly Hospital

Acute Care Hospitals · Mount Holly, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310057
Location175 Madison AveMount Holly, NJ 08060 · Burlington County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08103 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
$185.05 typical visit price
range $61.59 – $185.05
Typical copayment $46.26 (range $15.39 – $46.26)
Most-billed visit code 99205
Established Patient
$107.94 typical visit price
range $20.08 – $150.98
Typical copayment $26.98 (range $5.02 – $37.74)
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.

81.71/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality73.07
Promoting Interoperability100
Improvement Activities40
Cost55.39

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.

HOWARD ISADORE KESSELHEIM D.O.
Internal Medicine (Hematology & Oncology)
2 COOPER PLZ
CAMDEN, NJ 08103
Camden County (855) 632-2667
KATHRYN LANDERS M.D.
Otolaryngology
2 COOPER PLZ
CAMDEN, NJ 08103
Camden County (856) 632-2667
KANU P SHARAN MD
Internal Medicine (Hematology & Oncology)
2 COOPER PLZ
CAMDEN, NJ 08103
Camden County (855) 632-2667
EVELYN ROBLES-RODRIQUEZ RN, APN
Nurse Practitioner
2 COOPER PLZ, 400 HADDON AVE
CAMDEN, NJ 08103
Camden County (855) 632-2667
IROROEFE OLAYEMI FNP
Nurse Practitioner (Family)
2 COOPER PLZ
CAMDEN, NJ 08103
Camden County (855) 632-2667
CHRISTINA S CHU MD
Obstetrics & Gynecology (Gynecologic Oncology)
2 COOPER PLZ
CAMDEN, NJ 08103
Camden County (855) 632-2667
TERRY JEAN STYLES MD
Radiology (Radiation Oncology)
2 COOPER PLZ
CAMDEN, NJ 08103
Camden County (855) 632-2667
DANICA GIUGLIANO
Colon & Rectal Surgery
2 COOPER PLZ
CAMDEN, NJ 08103
Camden County (855) 632-2667

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 Sushil Ghimire's NPI number?

The NPI number for Sushil Ghimire is 1912314840. It was assigned to this individual provider in the NPPES registry on July 11, 2014.

Where is Sushil Ghimire located?

Sushil Ghimire practices at 2 Cooper Plz, Camden, NJ 08103. The listed phone number is (855) 632-2667.

What is Sushil Ghimire's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Is Sushil Ghimire enrolled in Medicare?

Yes. Sushil 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 Sushil Ghimire affiliated with any hospitals?

According to CMS data, Sushil Ghimire is affiliated with Cooper University Hospital and Virtua Mount Holly Hospital.

When was this NPI record last updated?

The NPPES record for Sushil Ghimire was last updated on August 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.