Active NPI 1922201003 Individual Practitioner Male Practitioner

Dr. Rajendra P Niraula , MD

Internal Medicine - Nephrology • Oxnard, CA

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Rajendra Niraula, MD is a certified Internal Medicine - Nephrology practicing in Oxnard, CA. With approximately 26 years of clinical experience since completing medical education in 2000, Dr. Niraula delivers high-quality medical care to the local community at 1200 W GONZALES RD.

Dr. Niraula maintains professional affiliations with Vista Del Mar Medical Group Inc, Community Memorial Health System and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include subsequent hospital care with moderate levelof medical decision making, if using time, at least, established patient outpatient office visit, dialysis services. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1200 W Gonzales Rd
Suite 300

Oxnard, CA 930363072

Telephone 8052789094

Fax 8052788918

Associated Practice Facility / Clinic

🏢 Vista Del Mar Medical Group, Inc Facility NPI 1942239694

Medicare Profile & Education

Medical School

Other

Graduation Year

2000

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine - Nephrology in Oxnard, CA

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

26 Yrs -4.4 yrs vs City Avg

City Avg: 30.4 Yrs

State Avg: 26.8 Yrs

Regional Practice Density

11 Specialists

Practicing in Oxnard, CA (1529 Statewide)

Telehealth Adoption Rate

63.6% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

32.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Niraula (26 Years) 26 Yrs

Oxnard Specialty Average (30.4 Years) 30.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	676	237	$150.00	$127.25
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	404	174	$150.00	$111.71
90960 Dialysis services, 4 or more physician visits per month (20 years or older)	400	44	$490.00	$387.50
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	138	122	$420.00	$186.79
90961 Dialysis services, 2-3 physician visits per month (20 years or older)	61	31	$420.00	$321.60
90962 Dialysis services, 1 physician visit per month (20 years or older)	32	11	$350.00	$224.73
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	29	29	$420.00	$244.20
99291 Critical care, first 30-74 minutes	22	18	$350.00	$227.45
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	18	15	$160.00	$106.13
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	15	11	$110.00	$85.13
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	13	13	$225.00	$189.97
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	12	12	$240.00	$145.25

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	642	222	$150.00	$125.14
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	425	177	$150.00	$106.27
90960 Dialysis services, 4 or more physician visits per month (20 years or older)	399	42	$490.00	$373.89
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	128	121	$420.00	$181.70
90961 Dialysis services, 2-3 physician visits per month (20 years or older)	48	24	$420.00	$312.78
99291 Critical care, first 30-74 minutes	40	35	$350.00	$222.54
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	33	33	$420.00	$232.37
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	11	11	$242.73	$166.58

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	621	222	$150.00	$107.84
90960 Dialysis services, 4 or more physician visits per month (20 years or older)	443	54	$490.00	$382.28
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	437	168	$150.00	$140.08
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	137	129	$420.00	$208.71
90970 Dialysis services, per day, less than full month service (20 years or older)	92	12	$35.00	$10.28
90961 Dialysis services, 2-3 physician visits per month (20 years or older)	52	29	$420.00	$319.00
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	28	23	$110.00	$75.12
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	26	26	$420.00	$239.04
99291 Critical care, first 30-74 minutes	23	21	$350.00	$228.10

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	569	184	$150.00	$110.40
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	487	187	$150.00	$143.31
90960 Dialysis services, 4 or more physician visits per month (20 years or older)	469	51	$490.00	$388.45
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	138	125	$420.00	$213.10
90961 Dialysis services, 2-3 physician visits per month (20 years or older)	56	31	$420.00	$323.67
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	42	42	$420.00	$244.32
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	37	26	$110.00	$76.95
99291 Critical care, first 30-74 minutes	25	23	$350.00	$233.35

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
90970 Dialysis services, per day, less than full month service (20 years or older)	535	17	$35.00	$8.84
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	518	184	$150.00	$120.25
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	483	190	$150.00	$112.31
90960 Dialysis services, 4 or more physician visits per month (20 years or older)	474	54	$490.00	$310.96
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	121	111	$420.00	$218.52
90961 Dialysis services, 2-3 physician visits per month (20 years or older)	53	24	$420.00	$263.09
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	48	31	$110.00	$78.19
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	37	37	$420.00	$228.69
99291 Critical care, first 30-74 minutes	22	18	$350.00	$238.04

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
90970 Dialysis services, per day, less than full month service (20 years or older)	1,821	47	$35.08	$8.26
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	647	215	$150.00	$110.51
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	551	208	$150.00	$119.12
90960 Dialysis services, 4 or more physician visits per month (20 years or older)	472	60	$489.30	$304.40
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	139	127	$400.58	$210.31
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	138	64	$110.00	$76.92
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	50	50	$420.00	$224.07
90961 Dialysis services, 2-3 physician visits per month (20 years or older)	28	13	$420.00	$257.38
99291 Critical care, first 30-74 minutes	20	18	$350.00	$234.05
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	12	12	$225.00	$159.25

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
90970 Dialysis services, per day, less than full month service (20 years or older)	1,912	51	$35.00	$8.02
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	622	222	$150.00	$116.47
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	497	223	$150.00	$108.31
90960 Dialysis services, 4 or more physician visits per month (20 years or older)	433	58	$490.00	$299.75
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	170	90	$110.00	$74.75
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	154	143	$420.00	$211.79
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	45	15	$65.00	$45.58
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	38	38	$420.00	$221.71
99213 Established patient office or other outpatient visit, typically 15 minutes	25	22	$120.00	$79.44
99291 Critical care, first 30-74 minutes	19	18	$350.00	$231.45
90961 Dialysis services, 2-3 physician visits per month (20 years or older)	19	11	$420.00	$253.38

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
90970 Dialysis services, per day, less than full month service (20 years or older)	1,244	34	$35.00	$8.26
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	574	198	$150.00	$115.86
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	473	190	$150.00	$109.96
90960 Dialysis services, 4 or more physician visits per month (20 years or older)	425	52	$490.00	$299.16
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	202	103	$110.00	$76.10
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	166	149	$420.00	$213.45
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	66	66	$420.00	$221.81
90961 Dialysis services, 2-3 physician visits per month (20 years or older)	21	15	$420.00	$253.18
90935 Hemodialysis procedure with physician evaluation	15	14	$560.00	$75.78

Medical Specialties & State Licenses

Internal Medicine - Nephrology Primary Specialty

NUCC Taxonomy Code: 207RN0300X

State License CA A106860

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

State License OH 35089409

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.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

State License CA A106860

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

ZZZ75566Z (CA)

Commercial Insurance / Payer ID Medicare Railroad

110039977 (CA)

Commercial Insurance / Payer ID Blue Cross

ZZZ34679Z (CA)

Hospital & Practice Group Affiliations

Community Memorial Health System

2721 E Main St, Ventura, CA 930032803

Phone: 8056672841

Vista Del Mar Medical Group Inc

242 E Harvard Blvd, Santa Paula, CA 930603372

Phone: 8055251500

Vista Del Mar Medical Group Inc

825 N 10th St, Santa Paula, CA 930601309

Phone: 8059338632

Vista Del Mar Medical Group Inc

147 N Brent St, Ventura, CA 930032809

Phone: 8056525011

Vista Del Mar Medical Group Inc

1600 N Rose Ave, Oxnard, CA 930303722

Phone: 8059882701

Vista Del Mar Medical Group Inc

4567 Telephone Rd, Ventura, CA 930035665

Phone: 8056446673

Vista Del Mar Medical Group Inc

1200 W Gonzales Rd, Oxnard, CA 930363075

Phone: 8059830691142

Vista Del Mar Medical Group Inc

1601 Raiders Way, Oxnard, CA 930335620

Phone: 8052403302