Dr. Niraj Niraula
- Gender: Male
- Experience: 17 years
- Graduation year: 2004
- Sole propriator: No
- NPI: 1215223722
Dr. Niraj Niraula MD
Pulmonologist
He is located at 4694 Belmont Avenue in Youngstown, OH 44505. Can help patients with the following: Atherosclerosis, Constipation, Cystic Fibrosis (CF), Emphysema, Smoking and Quitting Smoking, Urethritis. His National Provider Identifier (NPI) number is 1215223722. Appointment can be made via the phone number (330) 480-4080. He is affiliated with 2 practices and 1 hospitals.
Conditions treated
Dr. Niraj Niraula, being an pulmonologist, treats the following conditions. Please be advised that this list may not be complete. For the full list of conditions treated, consult directly with Dr. Niraj Niraula.
- Abdominal Pain
- Acute Pain
- Alpha-1 Antitrypsin Deficiency (AATD)
- Anemia
- Arthritis
- Asbestosis
- Asthma
- Atherosclerosis
- Bladder Control
- Blood Clots
- Bronchiectasis
- Bronchitis
- Chest Pain
- Cholecystitis
- Chronic Cough
- Chronic Obstructive Pulmonary Disease (COPD)
- Collapsed Lung
- Common Cold
- Constipation
- Cryptococcosis
- Cystic Fibrosis (CF)
- Cystitis
- Diarrhea
- Edema
- Embolism
- Emphysema
- Fever
- Gastroesophageal Reflux Disease (GERD)
- General Care
- Headache
- Heart Disease
- Hiatal Hernia
- High Blood Pressure
- Hot Flashes
- Hyperlipidemia
- Hyponatremia
- Influenza
- Inguinal Hernia
- Lung Cancer
- Migraine
- Nausea and Vomiting
- Obesity
- Osteoporosis
- Peptic Ulcer
- Pleural Effusion
- Pleurisy
- Pneumonia
- Prescription Refill
- Pulmonary Aspiration
- Pulmonary Embolism (PE)
- Pulmonary Fibrosis (PF)
- Pulmonary Hypertension (PH)
- Sarcoidosis
- Sleep Apnea
- Sleep Disorders
- Smoking and Quitting Smoking
- Tuberculosis (TB)
- Urethritis
- Urinary Tract Infection (UTI)
Procedures Performed by Dr. Niraj Niraula
ACA Marketplace (Obamacare/HealthCare.gov) plan networks
Insurers selling ACA Marketplace (HealthCare.gov) plans list Dr. Niraj Niraula as in-network for the following 2026 plans.
Health plans
Ambetter from Buckeye Health Plan
Network data as of Sep 15, 2026, as reported by the insurer.
Show all 16 plans from Ambetter from Buckeye Health Plan
| Plan | Plan type | Network tier | New patients |
|---|---|---|---|
| Choice Bronze HSA | HMO · Expanded Bronze | Preferred | Accepting new patients at some locations |
| Choice Bronze HSA + Vision + Adult Dental | HMO · Expanded Bronze | Preferred | Accepting new patients at some locations |
| Clear Gold | HMO · Gold | Preferred | Accepting new patients at some locations |
| Clear Gold + Vision + Adult Dental | HMO · Gold | Preferred | Accepting new patients at some locations |
| Complete Gold | HMO · Gold | Preferred | Accepting new patients at some locations |
| Complete Gold + Vision + Adult Dental | HMO · Gold | Preferred | Accepting new patients at some locations |
| Complete Silver | HMO · Silver | Preferred | Accepting new patients at some locations |
| Complete Silver + Vision + Adult Dental | HMO · Silver | Preferred | Accepting new patients at some locations |
| Everyday Bronze | HMO · Expanded Bronze | Preferred | Accepting new patients at some locations |
| Everyday Bronze + Vision + Adult Dental | HMO · Expanded Bronze | Preferred | Accepting new patients at some locations |
| Standard Expanded Bronze | HMO · Expanded Bronze | Preferred | Accepting new patients at some locations |
| Standard Expanded Bronze + Vision + Adult Dental | HMO · Expanded Bronze | Preferred | Accepting new patients at some locations |
| Standard Gold | HMO · Gold | Preferred | Accepting new patients at some locations |
| Standard Gold + Vision + Adult Dental | HMO · Gold | Preferred | Accepting new patients at some locations |
| Standard Silver | HMO · Silver | Preferred | Accepting new patients at some locations |
| Standard Silver + Vision + Adult Dental | HMO · Silver | Preferred | Accepting new patients at some locations |
Anthem Blue Cross and Blue Shield
Network data as of Sep 10, 2026, as reported by the insurer.
Show all 11 plans from Anthem Blue Cross and Blue Shield
| Plan | Plan type | Network tier | New patients |
|---|---|---|---|
| Anthem Bronze Pathway 10600 ($0 Virtual PCP + $0 Select Drugs) | HMO · Bronze | Participating | Accepting new patients |
| Anthem Bronze Pathway 10600 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) | HMO · Bronze | Participating | Accepting new patients |
| Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs) | HMO · Expanded Bronze | Participating | Accepting new patients |
| Anthem Bronze Pathway 8500 for HSA | HMO · Expanded Bronze | Participating | Accepting new patients |
| Anthem Gold Pathway 2000 Standard ($0 Virtual PCP + $0 Select Drugs) | HMO · Gold | Participating | Accepting new patients |
| Anthem Heart Healthy Bronze Pathway 6000 ($0 Virtual PCP + $0 Select Drugs) | HMO · Expanded Bronze | Participating | Accepting new patients |
| Anthem Heart Healthy Silver Pathway 5000 ($0 Virtual PCP + $0 Select Drugs) | HMO · Silver | Participating | Accepting new patients |
| Anthem Silver Pathway 4000 ($0 Virtual PCP + $0 Select Drugs) | HMO · Silver | Participating | Accepting new patients |
| Anthem Silver Pathway 4000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) | HMO · Silver | Participating | Accepting new patients |
| Anthem Silver Pathway 5500 for HSA | HMO · Silver | Participating | Accepting new patients |
| Anthem Silver Pathway 6000 Standard ($0 Virtual PCP + $0 Select Drugs) | HMO · Silver | Participating | Accepting new patients |
Antidote Health Plan of Ohio, Inc.
Network data as of Nov 9, 2025, as reported by the insurer.
Show all 15 plans from Antidote Health Plan of Ohio, Inc.
| Plan | Plan type | Network tier | New patients |
|---|---|---|---|
| Bronze Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx | HMO · Expanded Bronze | Tierone | Not accepting new patients |
| Bronze Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx | HMO · Expanded Bronze | Tierone | Not accepting new patients |
| Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx | HMO · Expanded Bronze | Tierone | Not accepting new patients |
| Bronze Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx | HMO · Expanded Bronze | Tierone | Not accepting new patients |
| Bronze Standard | HMO · Expanded Bronze | Tierone | Not accepting new patients |
| Gold Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx | HMO · Gold | Tierone | Not accepting new patients |
| Gold Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx | HMO · Gold | Tierone | Not accepting new patients |
| Gold Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx | HMO · Gold | Tierone | Not accepting new patients |
| Gold Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx | HMO · Gold | Tierone | Not accepting new patients |
| Gold Standard | HMO · Gold | Tierone | Not accepting new patients |
| Silver Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx | HMO · Silver | Tierone | Not accepting new patients |
| Silver Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx | HMO · Silver | Tierone | Not accepting new patients |
| Silver Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx | HMO · Silver | Tierone | Not accepting new patients |
| Silver Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx | HMO · Silver | Tierone | Not accepting new patients |
| Silver Standard | HMO · Silver | Tierone | Not accepting new patients |
CareSource
Network data as of Sep 15, 2026, as reported by the insurer.
Show all 21 plans from CareSource
| Plan | Plan type | Network tier | New patients |
|---|---|---|---|
| Bronze 7500 $25 Generic Drugs | HMO · Expanded Bronze | Preferred | Accepting new patients |
| Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness | HMO · Expanded Bronze | Preferred | Accepting new patients |
| Core Gold 1500 $10 Generic Drugs | HMO · Gold | Preferred | Accepting new patients |
| Core Gold 1500 $10 Generic Drugs + Adult Vision & Fitness | HMO · Gold | Preferred | Accepting new patients |
| Diabetes Gold 3000 $0 Chronic Care Drugs & Services | HMO · Gold | Preferred | Accepting new patients |
| Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness | HMO · Gold | Preferred | Accepting new patients |
| Diabetes Silver 5000 $0 Chronic Care Drugs & Services | HMO · Silver | Preferred | Accepting new patients |
| Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness | HMO · Silver | Preferred | Accepting new patients |
| Gold 2000 $15 Generic Drugs | HMO · Gold | Preferred | Accepting new patients |
| Gold 2000 $15 Generic Drugs + Adult Vision & Fitness | HMO · Gold | Preferred | Accepting new patients |
| HDHP Preventive Silver 5500 $0 Chronic Care Drugs | HMO · Silver | Preferred | Accepting new patients |
| Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services | HMO · Gold | Preferred | Accepting new patients |
| Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness | HMO · Gold | Preferred | Accepting new patients |
| Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services | HMO · Silver | Preferred | Accepting new patients |
| Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness | HMO · Silver | Preferred | Accepting new patients |
| Low Premium Bronze 10600 $25 Generic Drugs | HMO · Expanded Bronze | Preferred | Accepting new patients |
| Low Premium Bronze 10600 $25 Generic Drugs + Adult Vision & Fitness | HMO · Expanded Bronze | Preferred | Accepting new patients |
| Low Premium Silver 6200 $3 Generic Drugs | HMO · Silver | Preferred | Accepting new patients |
| Low Premium Silver 6200 $3 Generic Drugs + Adult Vision & Fitness | HMO · Silver | Preferred | Accepting new patients |
| Silver 6000 $20 Generic Drugs | HMO · Silver | Preferred | Accepting new patients |
| Silver 6000 $20 Generic Drugs + Adult Vision & Fitness | HMO · Silver | Preferred | Accepting new patients |
Oscar Health Insurance
Network data as of Sep 15, 2026, as reported by the insurer.
Show all 16 plans from Oscar Health Insurance
| Plan | Plan type | Network tier | New patients |
|---|---|---|---|
| Bronze Classic 4700 | HMO · Expanded Bronze | Preferred | Accepting new patients |
| Bronze Classic Standard | HMO · Expanded Bronze | Preferred | Accepting new patients |
| Bronze Elite + PCP Saver Plus | HMO · Expanded Bronze | Preferred | Accepting new patients |
| Bronze Simple Breathe Easy with Enhanced COPD Benefits | HMO · Expanded Bronze | Preferred | Accepting new patients |
| Bronze Simple Chronic Care CKM | HMO · Expanded Bronze | Preferred | Accepting new patients |
| Bronze Simple Diabetes | HMO · Expanded Bronze | Preferred | Accepting new patients |
| Gold Classic | HMO · Gold | Preferred | Accepting new patients |
| Gold Classic Standard | HMO · Gold | Preferred | Accepting new patients |
| Gold Elite Saver Plus | HMO · Gold | Preferred | Accepting new patients |
| Silver Classic Standard | HMO · Silver | Preferred | Accepting new patients |
| Silver Elite Saver Plus | HMO · Silver | Preferred | Accepting new patients |
| Silver Simple Breathe Easy with Enhanced COPD Benefits | HMO · Silver | Preferred | Accepting new patients |
| Silver Simple Chronic Care CKM | HMO · Silver | Preferred | Accepting new patients |
| Silver Simple Diabetes | HMO · Silver | Preferred | Accepting new patients |
| Silver Simple PCP Saver | HMO · Silver | Preferred | Accepting new patients |
| Silver Simple Women's Health with Menopause Benefits | HMO · Silver | Preferred | Accepting new patients |
UnitedHealthcare
Network data as of Sep 16, 2026, as reported by the insurer.
Show all 17 plans from UnitedHealthcare
| Plan | Plan type | Network tier | New patients |
|---|---|---|---|
| UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) | HMO · Expanded Bronze | Non Preferred | Not accepting new patients |
| UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) | HMO · Expanded Bronze | Non Preferred | Not accepting new patients |
| UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) | HMO · Bronze | Non Preferred | Not accepting new patients |
| UHC Bronze Standard (No Referrals) | HMO · Expanded Bronze | Non Preferred | Not accepting new patients |
| UHC Bronze Standard+ (Dental + Vision, No Referrals) | HMO · Expanded Bronze | Non Preferred | Not accepting new patients |
| UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) | HMO · Gold | Non Preferred | Not accepting new patients |
| UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) | HMO · Gold | Non Preferred | Not accepting new patients |
| UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) | HMO · Gold | Non Preferred | Not accepting new patients |
| UHC Gold Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) | HMO · Gold | Non Preferred | Not accepting new patients |
| UHC Gold Standard (No Referrals) | HMO · Gold | Non Preferred | Not accepting new patients |
| UHC Gold Standard+ (Dental + Vision, No Referrals) | HMO · Gold | Non Preferred | Not accepting new patients |
| UHC Silver Advantage ($0 Virtual Urgent Care, $8 Tier 2 Rx, No Referrals) | HMO · Silver | Non Preferred | Not accepting new patients |
| UHC Silver Advantage+ ($0 Virtual Urgent Care, $8 Tier 2 Rx, Dental + Vision, No Referrals) | HMO · Silver | Non Preferred | Not accepting new patients |
| UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) | HMO · Silver | Non Preferred | Not accepting new patients |
| UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) | HMO · Silver | Non Preferred | Not accepting new patients |
| UHC Silver Standard (No Referrals) | HMO · Silver | Non Preferred | Not accepting new patients |
| UHC Silver Standard+ (Dental + Vision, No Referrals) | HMO · Silver | Non Preferred | Not accepting new patients |
This covers ACA Marketplace plans only, as reported by each insurer. It does not include employer, Medicare Advantage, or state-run exchange plans, and a plan missing from this list does not mean Dr. Niraj Niraula is out of network. Insurer directories can be out of date, so always confirm with the insurer and the office before your visit.
Medicare Enrollment
Dr. Niraj Niraula is enrolled to bill Medicare as a Practitioner - Critical Care (intensivists) .
Bills through: Mercy Health Physicians Youngstown Specialty Care Llc
Based on Medicare's public enrollment records as of Jul 17, 2026. This reflects Medicare fee-for-service enrollment only and says nothing about other insurance, quality, outcomes, or board certification.
Payments received
Drug payment
| Veran Medical Technologies | $3276 |
| Covidien | $993 |
| Spiration | $692 |
Other
| Travel and Lodging | $4278 |
| Food and Beverage | $3583 |
Studies
Graduated in 2004Additional Specialities
- Internist
Questions & Answers
Has Dr. Niraj Niraula affiliation with hospitals?
Dr. Niraj Niraula is affiliated with SUMMA HEALTH SYSTEM.
Where can you meet with Dr. Niraj Niraula?
Dr. Niraj Niraula's office is located at 4694 Belmont Avenue in Youngstown, OH 44505.
What conditions does Dr. Niraj Niraula treat?
Dr. Niraj Niraula provides treatment for Atherosclerosis, Constipation, Cystic Fibrosis (CF), Emphysema, Smoking and Quitting Smoking, Urethritis. For the full list see this list.
Does Dr. Niraj Niraula have affiliation with practices?
Dr. Niraj Niraula is affiliated with Summa Health System. For the full list of practices see this list.
Does Dr. Niraj Niraula accept patients with Anthem Blue Cross and Blue Shield?
Yes, Dr. Niraj Niraula is listed in-network for Anthem Blue Cross and Blue Shield through the ACA Marketplace (Obamacare/HealthCare.gov). See the Marketplace plans section for details.