BIRENDRA NARAYAN LAL M.D.
NPI 1760437719
Internal Medicine in Denison, TX
NPI Status: Active since May 24, 2006
Contact Information
5016 S US HIGHWAY 75
ATTN: HOSPITALIST PROGRAM
DENISON, TX
ZIP 75020
Phone: (903) 416-4378
Fax: (903) 416-4980
- Individual
- Male
- Internal Medicine
- Accepts Insurance
- PECOS Enrolled
- Medicare Quality Reporting
About BIRENDRA LAL
This page provides the complete NPI Profile along with additional information for Birendra Lal, an internist established in Denison, Texas with a medical specialization in Internal Medicine. The healthcare provider is registered in the NPI registry with number 1760437719 assigned on May 2006. The practitioner's primary taxonomy code is 207R00000X with license number M2685 (TX). The provider is registered as an individual and his NPI record was last updated 13 years ago.
- NPI
- 1760437719
- Provider Name
- BIRENDRA NARAYAN LAL M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 5016 S US HIGHWAY 75 ATTN: HOSPITALIST PROGRAM DENISON, TX 75020
- Location Phone
- (903) 416-4378
- Location Fax
- (903) 416-4980
- Mailing Address
- 5016 S US HIGHWAY 75 ATTN: HOSPITALIST PROGRAM DENISON, TX 75020
- Mailing Phone
- (903) 416-4378
- Mailing Fax
- (903) 416-4980
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-24-2006
- Last Update Date
- 01-21-2013
- Code Navigator
An internist like Birendra Lal is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- M2685
- License State
- TX
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | M2685 (TX) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
- Blue Advantage Plus Gold? 803 - POS
- Blue Advantage Plus Gold? Standard - POS
- Blue Advantage Plus Silver? 202 - POS
- Blue Advantage Plus Silver? 605 - POS
- Blue Advantage Plus Silver? Standard - POS
- Blue Advantage Security HMO? 200 - HMO
- Blue Advantage Silver HMO? 205 - HMO
- Blue Advantage Silver HMO? 801 - HMO
- Blue Advantage Silver HMO? Standard - HMO
- MyBlue Health Bronze? 402 - HMO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Gold Classic - EPO
- Gold Classic Guided Care - HMO
- Gold Classic Standard - EPO
- Gold Classic Standard Guided Care - HMO
- Gold Elite - EPO
- Gold Simple Guided Care - HMO
- Silver Classic - EPO
- Silver Classic Standard - EPO
- Silver Classic Standard Guided Care - HMO
- Silver Simple Chronic Care CKM Guided Care - HMO
- Silver Simple Diabetes Guided Care - HMO
- Silver Simple Guided Care - HMO
- Silver Simple PCP Saver - EPO
- Silver Simple PCP Saver Guided Care - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| I44920 | MEDICARE UPIN (02) | ||
| 177215401 | MEDICAID (05) | TX | |
| 8G1324 | MEDICARE PIN (08) | TX |
Medicare Participation & PECOS Enrollment Status
Birendra Lal is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Initial hospital inpatient care per day, typically 50 minutes
Initial hospital inpatient care per day, typically 70 minutes
Initial hospital observation care per day, typically 70 minutes
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
This service was performed 20 times for 20 patientsInitial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
This service was performed 356 times for 337 patientsThis service involves a healthcare professional closely monitoring your health condition during your hospital stay. It typically lasts for about 70 minutes each day. This helps in timely detection of any changes in your health, allowing for immediate response and treatment.
This service was performed 43 times for 43 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 75020 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $126.4
- Minimum New Patient Price $54.84
- Maximum New Patient Price $166.88
- Average New Patient Copayment $31.6
- Minimum New Patient Copayment $13.71
- Maximum New Patient Copayment $41.72
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $97.05
- Minimum Established Patient Price $17.52
- Maximum Established Patient Price $136.11
- Average Established Patient Copayment $24.26
- Minimum Established Patient Copayment $4.38
- Maximum Established Patient Copayment $34.02
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Advance Care Planning | Yes | N/A |
| Implementation of practices/processes to develop advance care planning that includes: documenting the advance care plan or living will within the medical record, educating clinicians about advance care planning motivating them to address advance care planning needs of their patients, and how these needs can translate into quality improvement, educating clinicians on approaches and barriers to talking to patients about end-of-life and palliative care needs and ways to manage its documentation, as well as informing clinicians of the healthcare policy side of advance care planning. | ||
| Care Plan | 79% | 624 |
| Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Participation in an AHRQ-listed patient safety organization. | Yes | N/A |
| Participation in an AHRQ-listed patient safety organization. | ||
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 6 | 0 | 4 | 3 | 7 | 7 | 1 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 12 | 0 | 8 | 3 | 14 | 7 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 2 + 0 + 8 + 3 + 1 + 4 + 7 + 2 + 24 = 61 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 61 = 9 | 9 | ||||||||
The NPI number 1760437719 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1003893280 | DR. DREW CONLAN CASTLEBERRY MD Individual | Specialist | 5016 S US HIGHWAY 75 DENISON, TX 75020 (903) 892-1131 |
| 1053398271 | WILLIAM BROOKS FREY M.D. Individual | Specialist | 5016 S US HIGHWAY 75 RADIOLOGY DEPARTMENT DENISON, TX 75020 (903) 892-1131 |
| 1417062365 | SHERMAN RADIOLOGY ASSOCIATES Organization | Specialist | 5016 S US HIGHWAY 75 RADIOLOGY DEPARTMENT DENISON, TX 75020 (903) 892-1131 |
| 1073890430 | JANICE GAIL STEVENS RPH Individual | Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist) | 5016 S US HIGHWAY 75 DENISON, TX 75020 (903) 416-4066 |
| 1518235712 | PRINA SHAH PHARMD Individual | Pharmacist | 5016 S US HIGHWAY 75 TEXOMA MEDICAL CENTER DENISON, TX 75020 (903) 416-2066 |
| 1427003466 | CHARLES W DERBES JR. MD Individual | Internal Medicine | 5016 S US HIGHWAY 75 ATTN: TEXOMACARE HOSPITALIST PROGRAM DENISON, TX 75020 (903) 416-4378 |
| 1265457956 | ROBERT ROSS WATSON MD Individual | Internal Medicine | 5016 S US HIGHWAY 75 HOSPITALIST PROGRAM DENISON, TX 75020 (903) 416-4378 |
| 1063670628 | NASHEEL JOULES M.D. Individual | Internal Medicine | 5016 S US HIGHWAY 75 ATTN: TEXOMACARE HOSPITALIST PROGRAM DENISON, TX 75020 (903) 416-4378 |
| 1851616304 | DR. AZAR EHSAN M.D. Individual | Internal Medicine | 5016 S US HIGHWAY 75 ATTN: HOSPITALIST PROGRAM DENISON, TX 75020 (903) 416-4378 |
| 1518167022 | CASEY WADE POLLARD MD Individual | Radiology (Diagnostic Radiology) | 5016 S US HIGHWAY 75 RADIOLOGY DEPARTMENT DENISON, TX 75020 (903) 462-4184 |
| 1629024989 | ALVIN V DAVIS III MD Individual | Radiology (Diagnostic Radiology) | 5016 S US HIGHWAY 75 RADIOLOGY DEPT DENISON, TX 75020 (903) 892-1131 |
| 1104112572 | DR. BENJAMIN JAY BLAKE D.O. Individual | Emergency Medicine | 5016 S US HIGHWAY 75 DENISON, TX 75020 (903) 416-2435 |
| 1578540753 | DR. EDIZ I GURPINAR MD Individual | Specialist | 5016 S US HIGHWAY 75 RADIOLOGY DEPT SHERMAN, TX 75020 (903) 416-4000 |
| 1316111453 | HEATHER DANIELLE MORRIS DO Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 5016 S US HIGHWAY 75 DENISON, TX 75020 (903) 416-4270 |
| 1013343912 | WATERLOO PARK INPATIENT SERVICES PLLC Organization | Internal Medicine | 5016 S US HIGHWAY 75 DENISON, TX 75020 (973) 251-1132 |
| 1073928958 | STEPHEN BAIRD DO Individual | Pediatrics (Neonatal-Perinatal Medicine) | 5016 S US HIGHWAY 75 DENISON, TX 75020 (903) 416-4000 |
| 1922687227 | GABRIELLE GRALINO MS, RDN, LD Individual | Dietitian, Registered | 5016 S US HIGHWAY 75 DENISON, TX 75020 (903) 416-2111 |
| 1497334890 | REEVE REINSBOROUGH MS, RDN, LDN Individual | Dietitian, Registered | 5016 S US HIGHWAY 75 DENISON, TX 75020 (903) 416-2111 |
| 1043297260 | DR. JOE L NIEHUS MD Individual | Radiology (Diagnostic Radiology) | 5016 S US HIGHWAY 75 RADIOLOGY DEPARTMENT DENISON, TX 75020 (903) 892-1131 |
| 1396011771 | DR. JUSTIN MATTHEW BECKER D.O. Individual | Radiology (Diagnostic Radiology) | 5016 S US HIGHWAY 75 DENISON, TX 75020 (903) 465-1857 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1760437719, enumerated in the NPI registry as an "individual" on May 24, 2006
The provider is located at 5016 S Us Highway 75 Attn: Hospitalist Program Denison, Tx 75020 and the phone number is (903) 416-4378
The provider's speciality is Internal Medicine with taxonomy code 207R00000X
The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas, Oscar. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $126.4 with an average copayment of $31.6 for new patient appointments. Established patients should expect a typical charge of $97.05 and an average copayment of 24.26. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Initial hospital inpatient care per day, typically 50 minutes, Initial hospital inpatient care per day, typically 70 minutes and Initial hospital observation care per day, typically 70 minutes.
This NPI record was last updated on May 24, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.