Prajesh Ghimire, M.D.
NPI 1821300401 · Family Medicine Physician · Saratoga Springs, NY
Enrolled with Medicare as Practitioner - Family Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Prajesh Ghimire, M.D. is a Family Medicine Physician provider in Saratoga Springs, NY (NPI 1821300401).
Provider details
- NPI number
- 1821300401
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 2011-01067 (NC)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
15 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
1,288 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, at Least 35 Minutes99232 | 475 | $74 |
| Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, at Least 50 Minutes99233 | 459 | $112 |
| Initial Hospital Care With Moderate Level of Medical Decision Making, If Using Time, at Least 75 Minutes99223 | 188 | $163 |
| Hospital Discharge Day Management, More Than 30 Minutes99239 | 152 | $108 |
| Initial Hospital Care With Straightforward Or Low-Level Medical Decision Making, If Using Time, at Least 55 Minutes99222 | 14 | $123 |
Typical Medicare-allowed amounts for these services range $74–$163 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 9 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Pantoprazole Sodium | 34 | 17 |
| Apixabanbrand: Eliquis | 25 | 12 |
| Amoxicillin/Potassium Clavbrand: Amoxicillin-Clavulanate Potass | 21 | 21 |
| Prednisone | 21 | 20 |
| Metoprolol Succinate | 15 | — |
| Oxycodone Hcl | 15 | 15 |
Practice location
Mailing address
Registry dates
- Enumerated
- 2010-07-12
- Last updated
- 2023-08-21
- Certified
- 2023-08-21
Frequently asked questions
- What is Prajesh Ghimire's NPI number?
- Prajesh Ghimire's National Provider Identifier (NPI) is 1821300401, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Prajesh Ghimire's specialty?
- Prajesh Ghimire is listed in the NPPES registry with a primary specialty of Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Prajesh Ghimire located?
- Prajesh Ghimire's practice location on file with NPPES is 2 Tommy Luther Dr, Saratoga Springs, NY 12866-6054.
- What is Prajesh Ghimire's phone number?
- The practice phone number listed in the NPPES registry for Prajesh Ghimire is (518) 581-0892.
- Does Prajesh Ghimire accept Medicare?
- Prajesh Ghimire is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Prajesh Ghimire's NPI active?
- Yes — Prajesh Ghimire's NPI (1821300401) is active in the NPPES registry as of the last update on 2023-08-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.