CMS-1500 Box 24J / 33a • NPI
1295907301
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
208M00000X (CMS C6)
Licensed & Credentialed Allopathic & Osteopathic Physicians — Hospitalist
Box 32 Service Location & ZIP+4
2105 FOREST AVE, SAN JOSE, CA, 95128-1425
✓ 9-Digit EDI 837 ZIP+4 (95128-1425)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1295907301 (SUSHIL ADHIKARI, M.D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
✓ Eligible
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1295907301)
Medicare Beneficiaries
281
Total Billed Services
738
Distinct CPT/HCPCS Codes
10
Medicare Allowed Total
$80,447.36
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 46 |
99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 58 |
99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 37 |
99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 404 |
99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 35 |
99239 | Hospital discharge day management, more than 30 minutes | 153 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1295907301 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | SUSHIL ADHIKARI, M.D. |
| Plain-English Specialty | Licensed & Credentialed Allopathic & Osteopathic Physicians — Hospitalist NUCC Code: 208M00000X (Hospitalist) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 2105 FOREST AVE, SAN JOSE, CA, 95128-1425 |
| Practice Telephone / Fax | Tel: (408) 947-2500 |
| Administrative Mailing Address | 6480 GODANI ST, GILROY, CA, 95020-2719 |
| Enumeration & Last Sync | Enumerated: 2008-03-28 | CMS Record Updated: 2021-12-27 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
🗺️ Open in Google Maps 🏥 More Providers in SAN JOSE
🔒 Are you SUSHIL ADHIKARI, M.D.? Get your Verified NPI Clinic Badge or request personal phone/address redaction →
Plain-English Taxonomy & CMS Crosswalk (208M00000X)
What Does Taxonomy Code 208M00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 208M00000X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Hospitalist"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (SUSHIL ADHIKARI, M.D.)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207R00000X — Internal MedicinePlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: MN | License: 52732 | Primary: Secondary |
207R00000X — Internal MedicinePlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: IL | License: 125053284 | Primary: Secondary |
207R00000X — Internal MedicinePlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: IL | License: 036124008 | Primary: Secondary |
208M00000X — HospitalistPlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Hospitalist | State: CA | License: C171400 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
Batch-verify up to 25 NPIs free against CMS NPPES + Medicare PECOS + HHS OIG Exclusions with 1-click CSV export.