SURAJA SHRESTHA BASTOLA (DNP) – Nurse Practitioner, NPI 1407566771

SURAJA SHRESTHA BASTOLA (DNP) is a healthcare provider. based in Medford, Oregon. specializing in NURSE PRACTITIONER. They hold the professional credentials DNP. They hold a License No. 201907141RN (OR). The NPI Number for SURAJA SHRESTHA BASTOLA (DNP) is 1407566771

Main info

Female
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
SURAJA SHRESTHA BASTOLA (DNP)
NPI
1407566771
Phone
(248) 571-2787
Address
2845 MORNING VIEW DR
Enumeration Date
28 November 2022
Last Update Date
5 December 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9712065164
Graduation Year
2022 (4 years ago)
PAC ID
2264881135
Group Practice PAC ID
2860827821
Professional Enrollment ID
I20231218003005
Address ID
OR972224628MI4560XWAYX403
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:3State licenses:2Digital endpointsOther names

3,379 NURSE PRACTITIONER in OR

Provider Addresses for SURAJA SHRESTHA BASTOLA (DNP)

  • 2845 MORNING VIEW DR

    MEDFORD, OR 975045944

    Phone: (248) 571-2787

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-12-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231218003005INurse PractitionerORTBD
I20231218003321INurse PractitionerWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97504)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2860827821View full group profile
NameSpecialtyState
Nurse PractitionerOR
-OR
Internal MedicineOR
Nurse PractitionerOR
Nurse PractitionerOR
Nurse PractitionerOR
Nurse PractitionerOR
-OR
Physician AssistantCA
Internal MedicineOR

Reviews

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Frequently asked questions

What is SURAJA SHRESTHA BASTOLA (DNP)'s NPI number?
SURAJA SHRESTHA BASTOLA (DNP)'s NPI is 1407566771 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to SURAJA SHRESTHA BASTOLA (DNP)?
You should see SURAJA SHRESTHA BASTOLA (DNP) as active in CMS-hosted NPPES data.
What area of care is associated with SURAJA SHRESTHA BASTOLA (DNP)?
SURAJA SHRESTHA BASTOLA (DNP)'s record emphasizes Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is SURAJA SHRESTHA BASTOLA (DNP) associated with Medford?
Public fields place SURAJA SHRESTHA BASTOLA (DNP) around Medford, Oregon. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for SURAJA SHRESTHA BASTOLA (DNP) is noted as November 28, 2022 where the registry provides it.

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