GAUTAM J SHAH M. D.
NPI 1063859502
Internal Medicine in Encinitas, CA

Active since May 23, 2013PECOS EnrolledAccepts Medicare Assignment
89.98/100
CMS Quality Rating
354 SANTA FE DR, ENCINITAS, CA 92024(760) 230-2251(760) 230-2253 Get Directions Write a Review

NPPES record last updated: May 23, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Gautam J Shah M. D. NPPES

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

GAUTAM J SHAH M. D. (NPI 1063859502) is an individual internal medicine provider in Encinitas, California, licensed in California (A133106) and active in the NPI registry since May 2013. He is enrolled in Medicare PECOS and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (2013).

NPPES Registry Identity

NPI1063859502
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameGAUTAM J SHAHCredential: M. D.
Location Address354 SANTA FE DREncinitas, CA 92024-5142
Mailing AddressPo Box 231189Encinitas, CA 92023-1189 · (730) 230-2251
Fax(760) 230-2253
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 2013
Enumeration DateMay 23, 2013
Last NPPES UpdateMay 23, 2016
NPI 1063859502 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 CA · A133106
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.

354 SANTA FE DR, Encinitas, CA 92024

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

Gautam J Shah M. D. 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 ID7517259955
PECOS Enrollment IDI20160706000823
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 3

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.
582 services252 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.
253 services239 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.
66 services66 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92024 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
$140.22 typical visit price
range $62.10 – $184.71
Typical copayment $35.05 (range $15.52 – $46.17)
Most-billed visit code 99204
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
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.

89.98/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality100
Improvement Activities0
Cost97.55

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers15 claims15 services$63.27 avg. paid by Medicare
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738
DME-Oxygen and Supplies · category DC000N
1 supplier13 claims13 services$32.07 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

Occupational Therapist
354 SANTA FE DR
ENCINITAS, CA 92024
Student in an Organized Health Care Education/Training Program
354 SANTA FE DR
ENCINITAS, CA 92024
Obstetrics & Gynecology
354 SANTA FE DR
ENCINITAS, CA 92024
Internal Medicine
354 SANTA FE DR
ENCINITAS, CA 92024
Emergency Medicine
354 SANTA FE DR
ENCINITAS, CA 92024
Internal Medicine
354 SANTA FE DR
ENCINITAS, CA 92024
Emergency Medicine
354 SANTA FE DR
ENCINITAS, CA 92024
Physician Assistant (Medical)
354 SANTA FE DR
ENCINITAS, CA 92024

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 Gautam Shah's NPI number?

The NPI number for Gautam Shah is 1063859502. It was assigned to this individual provider in the NPPES registry on May 23, 2013.

Where is Gautam Shah located?

Gautam Shah practices at 354 Santa Fe Dr, Encinitas, CA 92024. The listed phone number is (760) 230-2251.

What is Gautam Shah's specialty?

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

Is Gautam Shah enrolled in Medicare?

Yes. Gautam 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.

When was this NPI record last updated?

The NPPES record for Gautam Shah was last updated on May 23, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.