Sanjay Poudel, MBBS
NPI 1972164853 · Internal Medicine Physician · Providence, RI
Enrolled with Medicare as Practitioner - Internal Medicine · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Sanjay Poudel, MBBS is a Internal Medicine Physician provider in Providence, RI (NPI 1972164853).
Provider details
- NPI number
- 1972164853
- Entity type
- Individual
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- MBBS
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Student, Health Care
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
6 yrs in NPPES registry
- Profile completeness28% of score
83% of core fields populated
- Practice footprint17% of score
2 documented practice locations
- Medicare service volume (vs. specialty peers)28% of score
328 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 | 117 | $78 |
| Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, at Least 50 Minutes99233 | 100 | $117 |
| Initial Hospital Care With Moderate Level of Medical Decision Making, If Using Time, at Least 75 Minutes99223 | 43 | $171 |
| Hospital Discharge Day Management, 30 Minutes Or Less99238 | 28 | $80 |
| Hospital Discharge Day Management, More Than 30 Minutes99239 | 25 | $113 |
| Initial Hospital Care With Straightforward Or Low-Level Medical Decision Making, If Using Time, at Least 55 Minutes99222 | 15 |
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 1 distinct drug on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Amoxicillin/Potassium Clavbrand: Amoxicillin-Clavulanate Potass | 18 | 18 |
Medicare Part D only. These counts cover prescriptions paid through Medicare Part D in 2024 — they do notinclude cash-pay, commercial-insurance, Medicaid, or Part B–administered drugs, and badly undercount high cash-pay categories (e.g. GLP-1 weight-loss, testosterone, and ED medications). Any drug with 10 or fewer claims is omitted by CMS, and beneficiary counts under 11 are suppressed — so a missing drug means no Part D record, never zero. This is a factual claims summary, not an endorsement, not medical advice, and not a consumer report. Source: CMS Medicare Part D Prescribers — by Provider and Drug.
Practice location
Mailing address
Additional practice locations (1)
- 2401 W Belvedere AveBaltimore, MD 21215-5270Phone: (410) 601-7639
Registry dates
- Enumerated
- 2019-06-22
- Last updated
- 2022-06-17
- Certified
- 2022-06-17
Frequently asked questions
- What is Sanjay Poudel's NPI number?
- Sanjay Poudel's National Provider Identifier (NPI) is 1972164853, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Sanjay Poudel's specialty?
- Sanjay Poudel is listed in the NPPES registry with a primary specialty of Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Sanjay Poudel located?
- Sanjay Poudel's practice location on file with NPPES is 164 Summit Ave, Providence, RI 02906-2894.
- What is Sanjay Poudel's phone number?
- The practice phone number listed in the NPPES registry for Sanjay Poudel is (401) 793-4489.
- Does Sanjay Poudel accept Medicare?
- Sanjay Poudel is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Sanjay Poudel's NPI active?
- Yes — Sanjay Poudel's NPI (1972164853) is active in the NPPES registry as of the last update on 2022-06-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.