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DHIRAJ SHAH MD
NPI 1053965392
Internal Medicine in Marion, IN

Active since July 25, 2019PECOS EnrolledAccepts Medicare Assignment
83.71/100
CMS Quality Rating
441 N WABASH AVE, MARION, IN 46952(765) 662-4236(765) 662-4903 Get Directions Write a Review

NPPES record last updated: November 8, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 8, 2022, Jul 7, 2022, Jul 25, 2019 (3 updates tracked since 2019).

About Dhiraj Shah Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DHIRAJ SHAH MD (NPI 1053965392) is an individual internal medicine provider in Marion, Indiana, licensed in Indiana (01087976A) and active in the NPI registry since July 2019. He is enrolled in Medicare PECOS, is affiliated with Marion General Hospital, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1053965392
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDHIRAJ SHAHCredential: MD
Location Address441 N WABASH AVEMarion, IN 46952-2612
Mailing Address330 N Wabash Ave Ste G-20Marion, IN 46952-2605 · (765) 660-7616
Phone(765) 662-4236
Fax(765) 662-4903
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateJuly 25, 2019
Last NPPES UpdateNovember 8, 20223 updates tracked since enumeration
NPPES CertifiedNovember 8, 2022
✔ NPI 1053965392 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IN · 01087976A
Definition
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.
Also ListedHospitalistTaxonomy 208M00000X · License 01087976A (IN)
441 N WABASH AVE, Marion, IN 46952
Open in Google Maps ↗

Other Identifiers 1

Other1102638432IN · Anthem

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dhiraj Shah Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8123404944
PECOS Enrollment IDI20221003000905
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
206 services79 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
94 services46 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
91 services88 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
48 services47 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial 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.
46 services44 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
16 services16 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Marion General Hospital

Acute Care Hospitals · Marion, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150011
Location441 N Wabash AveMarion, IN 46952 · Grant County
Emergency services Birthing friendly

Lutheran Hospital Of Indiana

Acute Care Hospitals · Fort Wayne, IN
3/5 CMS rating
OwnershipProprietary
CMS Certification Number150017
Location7950 W Jefferson BlvdFort Wayne, IN 46804 · Allen County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46952 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$122.49 typical visit price
range $53.07 – $161.76
Typical copayment $30.62 (range $13.26 – $40.44)
Most-billed visit code 99204
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.71/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality69.94
Promoting Interoperability95
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. ROBERT JOSEPH SIMMONS RD, LD
Dietitian, Registered
441 N WABASH AVE
MARION, IN 46952
Grant County (765) 660-7133
MARION ANESTHESIOLOGY, PC
Anesthesiology
441 N WABASH AVE
MARION, IN 46952
Grant County (765) 662-3320
NIKA T. BALL OTR/L
Occupational Therapist
441 N WABASH AVE
MARION, IN 46952
Grant County (765) 662-4697
DR. ANGELA LEIGH CATES PHARMD
Pharmacist
441 N WABASH AVE
MARION, IN 46952
Grant County (765) 662-4621
MARION GENERAL HOSPITAL
Pharmacy (Community/Retail Pharmacy)
441 N WABASH AVE
MARION, IN 46952
Grant County (765) 660-6010
KENNETH EDWARD GALLAGHER MD
Pathology (Anatomic Pathology & Clinical Pathology)
441 N WABASH AVE
MARION, IN 46952
Grant County (765) 662-4648
ADEWALE TAIWO OYENEYE MD
Student in an Organized Health Care Education/Training Program
441 N WABASH AVE
MARION, IN 46952
Grant County (765) 660-6000
BAILEY STEWART BERELSMAN
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
441 N WABASH AVE
MARION, IN 46952
Grant County (765) 665-6020

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dhiraj Shah's NPI number?

The NPI number for Dhiraj Shah is 1053965392. It was assigned to this individual provider in the NPPES registry on July 25, 2019.

Where is Dhiraj Shah located?

Dhiraj Shah practices at 441 N Wabash Ave, Marion, IN 46952. The listed phone number is (765) 662-4236.

What is Dhiraj Shah's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Dhiraj Shah enrolled in Medicare?

Yes. Dhiraj Shah is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Dhiraj Shah accept?

Health plans from CareSource list Dhiraj Shah as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Dhiraj Shah affiliated with any hospitals?

According to CMS data, Dhiraj Shah is affiliated with Marion General Hospital and Lutheran Hospital Of Indiana.

When was this NPI record last updated?

The NPPES record for Dhiraj Shah was last updated on November 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.