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DR. PRAMESH BARAL M
NPI 1912516022
Family Medicine in Rio Rancho, NM

Active since July 24, 2020PECOS EnrolledAccepts Medicare Assignment
83.84/100
CMS Quality Rating
3777 NM-528 NE, RIO RANCHO, NM 87144(505) 404-2590 Get Directions Write a Review

NPPES record last updated: October 18, 2023. Verified against the NPPES registry weekly; last sync: September 20, 2026.

Record update history: Oct 18, 2023, Jul 24, 2020 (2 updates tracked since 2020).

About Dr. Pramesh Baral M NPPES

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

DR. PRAMESH BARAL M (NPI 1912516022) is an individual family medicine provider in Rio Rancho, New Mexico, licensed in New Mexico (MD2023-0290) and active in the NPI registry since July 2020. He is enrolled in Medicare PECOS, is affiliated with Presbyterian Hospital, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1912516022
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. PRAMESH BARALCredential: M
Location Address3777 NM-528 NERio Rancho, NM 87144
Mailing Address3777 Nm-528 NeRio Rancho, NM 87144 · (505) 404-2590
Phone(505) 404-2590
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateJuly 24, 2020
Last NPPES UpdateOctober 18, 20232 updates tracked since enumeration
NPPES CertifiedOctober 16, 2023
✔ NPI 1912516022 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NM · MD2023-0290
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.
3777 NM-528 NE, Rio Rancho, NM 87144
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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

Dr. Pramesh Baral M 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 ID648696955
PECOS Enrollment IDI20230714000225
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 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.

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.
478 services220 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
32 services32 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.
30 services29 patients

Hospital Affiliations CMS Care Compare

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

Presbyterian Hospital

Acute Care Hospitals · Albuquerque, NM
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number320021
Location1100 Central Avenue SEAlbuquerque, NM 87106 · Bernalillo County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87144 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
$84.79 typical visit price
range $54.26 – $166.80
Typical copayment $21.19 (range $13.56 – $41.70)
Most-billed visit code 99203
Established Patient
$96.38 typical visit price
range $17.00 – $135.35
Typical copayment $24.09 (range $4.25 – $33.83)
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.

83.84/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality84.59
Promoting Interoperability100
Improvement Activities40
Cost58.63

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 Pramesh Baral's NPI number?

The NPI number for Pramesh Baral is 1912516022. It was assigned to this individual provider in the NPPES registry on July 24, 2020.

Where is Pramesh Baral located?

Pramesh Baral practices at 3777 Nm-528 NE, Rio Rancho, NM 87144. The listed phone number is (505) 404-2590.

What is Pramesh Baral's specialty?

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

Is Pramesh Baral enrolled in Medicare?

Yes. Pramesh Baral 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 Pramesh Baral affiliated with any hospitals?

According to CMS data, Pramesh Baral is affiliated with Presbyterian Hospital.

When was this NPI record last updated?

The NPPES record for Pramesh Baral was last updated on October 18, 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.