Individual provider Active NPI

Rajendra Prasad Koirala, M.D.

  • Psychiatry Physician
  • Youngstown, OH
National Provider Identifier
1952588972
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35.091058 Issued in OH
Practice address
725 Boardman Canfield Rd Ste L1
Youngstown, OH 44512
Phone
(234) 254-0612
NPI assigned
Jan 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35.091058 OH Primary

Addresses

Primary practice location

725 Boardman Canfield Rd Ste L1
Youngstown, OH 44512

Mailing address

725 Boardman Canfield Rd Ste L1
Youngstown, OH 44512-4370
Phone (234) 254-0612

Other identifiers 2

IdentifierTypeStateIssuer
11930689OtherOHCAQH
2902836MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20090206000156 OH Practitioner - Psychiatry 8426133885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rajendra P Koirala, M.D., LLCGroup PAC ID 8820334931, 23 clinicians

Practice addresses (Care Compare)

725 Boardman Canfield Rd
Suite L1
Boardman, OH 44512-4370
Phone (330) 330-8655

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.091058OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Lima, LLC Psychiatry Past Accepting new patients
Psycare Inc Past Accepting new patients
Rajendra P Koirala, M.D., LLC Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Rajendra P Koirala, M.D., LLC Psychiatry Past Accepting new patients
Rajendra P Koirala, M.D., LLC Past Accepting new patients

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1952588972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 BOARDMAN CANFIELD RD STE L1",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445124370",
            "telephone_number": "234-254-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 BOARDMAN CANFIELD RD STE L1",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "44512",
            "telephone_number": "234-254-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOIRALA",
        "first_name": "RAJENDRA",
        "middle_name": "PRASAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-22",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.091058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11930689",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2902836",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.