DR. NATALIA A. SHRESTHA M.D.
NPI 1952366965
Internal Medicine in Lexington, KY

Active since April 20, 2006PECOS EnrolledAccepts Medicare Assignment
86.62/100
CMS Quality Rating
1221 S BROADWAY, LEXINGTON, KY 40504(859) 277-1570(859) 277-1595 Get Directions Write a Review

NPPES record last updated: February 18, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Natalia A. Shrestha M.d. NPPES

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

DR. NATALIA A. SHRESTHA M.D. (NPI 1952366965) is an individual internal medicine provider in Lexington, Kentucky, licensed in Kentucky (33206) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS, is affiliated with Saint Joseph Hospital, and is a graduate of University Of Kentucky College Of Medicine (1996).

NPPES Registry Identity

NPI1952366965
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. NATALIA A. SHRESTHACredential: M.D.
Location Address1221 S BROADWAYLexington, KY 40504-2701
Mailing Address1221 S BroadwayLexington, KY 40504-2701 · (859) 277-1570 · Fax (859) 277-1595
Fax(859) 277-1595
Sole ProprietorNo
Medical School CMSUniversity Of Kentucky College Of MedicineGraduated 1996
Enumeration DateApril 20, 2006
Last NPPES UpdateFebruary 18, 2021
NPPES CertifiedFebruary 18, 2021
NPI 1952366965 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in KY · 33206
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.

1221 S BROADWAY, Lexington, KY 40504

Other Identifiers 1

Medicaid64332067KY

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. Natalia A. Shrestha 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 ID7416845235
PECOS Enrollment IDI20040304000936
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 8

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 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.
432 services332 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.
320 services320 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.
290 services195 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
242 services242 patients
Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) G0296
This visit involves discussing the necessity of a lung cancer screening using a low dose CT scan. It's a chance to determine if you're eligible for the test and to make an informed decision about proceeding. The scan can potentially detect lung cancer early, improving treatment outcomes.
23 services22 patients
Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402
An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.
14 services14 patients

Hospital Affiliations CMS Care Compare 4

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

Saint Joseph Hospital

Acute Care Hospitals · Lexington, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number180010
LocationOne Saint Joseph DriveLexington, KY 40504 · Fayette County
Emergency services

University Of Kentucky Hospital

Acute Care Hospitals · Lexington, KY
3/5 CMS rating
OwnershipGovernment - State
CMS Certification Number180067
Location800 Rose StreetLexington, KY 40536 · Fayette County
Emergency services Birthing friendly

Baptist Health Lexington

Acute Care Hospitals · Lexington, KY
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number180103
Location1740 Nicholasville RoadLexington, KY 40503 · Fayette County
Emergency services Birthing friendly

Saint Joseph East

Acute Care Hospitals · Lexington, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180143
Location150 North Eagle Creek DriveLexington, KY 40509 · Fayette County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40504 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
$122.77 typical visit price
range $52.76 – $162.27
Typical copayment $30.69 (range $13.19 – $40.56)
Most-billed visit code 99204
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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.

86.62/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality95.79
Promoting Interoperability100
Improvement Activities40
Cost59.63

Reported Quality Measures

Breast Cancer Screening
80%600 patients4/55-star benchmark: 93%
Cervical Cancer Screening
62%604 patients3/55-star benchmark: 98%
Colorectal Cancer Screening
88%932 patients5/55-star benchmark: 88%
Controlling High Blood Pressure
76%469 patients4/55-star benchmark: 91%
Diabetes: Eye Exam
53%192 patients3/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
18%192 patients4/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
100%3,410 patients5/55-star benchmark: 100%
e-Prescribing
100%4,377 patients5/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
61%1,551 patients3/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
56%1,138 patients3/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 78% · 1,544 patients
Patients screened: 78% · 1,544 patients
93%116 patients4/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
86%1,246 patients4/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
80%335 patients4/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 2% · 750 patients
Patients totalRate: 13% · 801 patients
13%801 patients3/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 7

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
9 suppliers21 claims34 services$6.16 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
7 suppliers12 claims67 services$2.42 avg. paid by Medicare
Hospital bed, variable height, hi-lo, with any type side rails, with mattress E0255
DME-Hospital Beds · category DB000N
1 supplier12 claims12 services$43.59 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
2 suppliers17 claims17 services$91.35 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$34.10 avg. paid by Medicare
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme J7620
DME-Drugs Administered Through DME · category DG006N
2 suppliers13 claims1,680 services$0.08 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 20

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

Radiology (Body Imaging)
1221 S BROADWAY
LEXINGTON, KY 40504
Nurse Practitioner
1221 S BROADWAY
LEXINGTON, KY 40504
Nurse Practitioner
1221 S BROADWAY
LEXINGTON, KY 40504
Internal Medicine
1221 S BROADWAY
LEXINGTON, KY 40504
Radiology (Diagnostic Radiology)
1221 S BROADWAY
LEXINGTON, KY 40504
Nurse Practitioner (Family)
1221 S BROADWAY
LEXINGTON, KY 40504
Nurse Practitioner
1221 S BROADWAY
LEXINGTON, KY 40504
Emergency Medicine
1221 S BROADWAY
LEXINGTON, KY 40504

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 Natalia Shrestha's NPI number?

The NPI number for Natalia Shrestha is 1952366965. It was assigned to this individual provider in the NPPES registry on April 20, 2006.

Where is Natalia Shrestha located?

Natalia Shrestha practices at 1221 S Broadway, Lexington, KY 40504. The listed phone number is (859) 277-1570.

What is Natalia Shrestha's specialty?

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

Is Natalia Shrestha enrolled in Medicare?

Yes. Natalia Shrestha 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 Natalia Shrestha affiliated with any hospitals?

According to CMS data, Natalia Shrestha is affiliated with Saint Joseph Hospital, University Of Kentucky Hospital, Baptist Health Lexington and Saint Joseph East.

When was this NPI record last updated?

The NPPES record for Natalia Shrestha was last updated on February 18, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.