Individual provider Active NPI

Dibas Koirala, M.D

  • Family Medicine Physician
  • Greensboro, NC
National Provider Identifier
1417187790
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2009-01302 Issued in NC
Practice address
3800 Robert Porcher Way
Suite 200
Greensboro, NC 27410-2557
Phone
(336) 282-0376
Fax
(336) 282-0376
NPI assigned
Jul 21, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2009-01302 NC Primary

Addresses

Primary practice location

3800 Robert Porcher Way
Suite 200
Greensboro, NC 27410-2557

Mailing address

PO Box 14883
Greensboro, NC 27415-4883
Phone (336) 274-6515

Other identifiers 4

IdentifierTypeStateIssuer
154NCOtherNCBCBS OF NC
5196035OtherNCCIGNA
5913191MedicaidNC
9378613OtherNCAETNA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dibas.koirala@eaglep.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090918000340 NC Practitioner - Family Practice 7416003264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3800 Robert Porcher Way
Suite 200
Greensboro, NC 27410-2559
Phone (336) 282-0376

Hospital & facility affiliations

  • Bayada Home Health Care, Inc Home health agency, Greensboro, NC, CCN 347211
  • Adoration Home Health Home health agency, High Point, NC, CCN 347125
  • Moses H. Cone Memorial Hospital, the Hospital, Greensboro, NC, CCN 340091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2009-01302NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Physicians and Associates PA CurrentSince Mar 7, 2011 Accepting new patients
Eagle Physicians and Associates PA Family Medicine CurrentSince Mar 7, 2011 Accepting new patients
Eagle Physicians and Associates PA Past Accepting new patients
Eagle Physicians and Associates PA Past Accepting new patients
BRMG-PC Family Medicine Past Accepting new patients
Eagle Physicians and Associates PA Past Accepting new patients

Locations

3800 Robert Porcher Way
Ste 200
Greensboro, NC 27410
Phone (336) 268-3280

324 W Wendover Ave
Ste 200
Greensboro, NC 27408
Phone (336) 274-6515

Interoperability endpoints

  • Direct secure messaging: dibas.koirala@eaglep.eclinicaldirectplus.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1417187790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14883",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274154883",
            "telephone_number": "336-274-6515",
            "fax_number": "336-275-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 ROBERT PORCHER WAY",
            "address_2": "SUITE 200",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102557",
            "telephone_number": "336-282-0376",
            "fax_number": "336-282-0376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOIRALA",
        "first_name": "DIBAS",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-21",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2009-01302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "154NC",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5196035",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5913191",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9378613",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dibas.koirala@eaglep.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "3800 Robert Porcher Way",
            "address_2": "suite 200",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274102557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.