HIRAL N. SHAH MD
NPI 1093862666
Internal Medicine - Gastroenterology in Allentown, PA

Q: What is Hiral Shah's NPI number?

The NPI number for Hiral Shah is 1093862666. It was assigned to this individual provider in the NPPES registry on January 4, 2007.

Q: What is Hiral Shah's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Hiral Shah was last updated on May 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since January 04, 2007PECOS EnrolledAccepts Medicare Assignment

1501 N CEDARCREST BLVD, SUITE 110 EPGI & LIVER SPECIALISTS, ALLENTOWN, PA 18104(610) 821-2828(610) 821-7915 Get Directions Write a Review

NPPES record last updated: May 26, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Hiral N. Shah Md NPPES

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

HIRAL N. SHAH MD (NPI 1093862666) is an individual gastroenterology provider in Allentown, Pennsylvania, licensed in Pennsylvania (MD438697) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, is affiliated with Schuylkill Medical Center - South Jackson Street, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1093862666

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameHIRAL N. SHAHCredential: MD

Location Address1501 N CEDARCREST BLVD, SUITE 110 EPGI & LIVER SPECIALISTSAllentown, PA 18104

Mailing Address1501 N Cedar Crest Blvd, Suite 110Allentown, PA 18104-2309 · (610) 821-2828 · Fax (610) 821-7915

Phone(610) 821-2828

Fax(610) 821-7915

Sole ProprietorNo

Medical School CMSOtherGraduated 2003

Enumeration DateJanuary 4, 2007

Last NPPES UpdateMay 26, 2021

NPPES CertifiedMay 26, 2021

✔ NPI 1093862666 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in PA · MD438697

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Also ListedInternal MedicineTaxonomy 207R00000X · License MD036181 (DC)

1501 N CEDARCREST BLVD, Allentown, PA 18104

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Hiral N. 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 ID840366381

PECOS Enrollment IDI20100602000419

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.

Medicare Billing Reassignments

Medicare enrollment records show Hiral Shah reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Eastern Pennsylvania Gastroenterology & Liver Specialists P C

Same address

Gastroenterology

1501 N CEDAR CREST BLVD STE 110
Allentown, PA 18104

Reassigned Medicare billing, Pennsylvania enrollment
27 clinicians in this Medicare group

NPI 1104874064 (610) 821-2828

Lehigh Valley Physician Group

0.1 mi

Family Medicine

1503 N CEDAR CREST BLVD
Allentown, PA 18104

Reassigned Medicare billing, Pennsylvania enrollment
2,895 clinicians in this Medicare group

NPI 1386397222 (610) 861-8080

Via Affiliates

28 mi

Specialist

777 FERRY RD
Doylestown, PA 18901

Reassigned Medicare billing, Pennsylvania enrollment
268 clinicians in this Medicare group

NPI 1386136364 (267) 370-5296

Family Care Centers Inc

32 mi

Family Medicine

200 E BROWN ST
East Stroudsburg, PA 18301

Reassigned Medicare billing, Pennsylvania enrollment
500 clinicians in this Medicare group

NPI 1316409626 (570) 476-3700

Integrated Medical Group P C

35 mi

Family Medicine

82 TUNNEL RD
Pottsville, PA 17901

Reassigned Medicare billing, Pennsylvania enrollment
124 clinicians in this Medicare group

NPI 1336102268 (570) 622-5455

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 17

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.

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

95 services91 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

67 services66 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

50 services49 patients

Ultrasound exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43259

This procedure involves a flexible tube with a camera, called an endoscope, inserted through your mouth to examine your esophagus, stomach, and upper small bowel. An ultrasound device on the endoscope helps get detailed images. It's safe and helps diagnose various conditions.

46 services45 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

31 services30 patients

Removal of stone or debris from bile or pancreatic duct using a flexible endoscope 43264

This procedure, called an endoscopic retrograde cholangiopancreatography (ERCP), involves using a flexible tube with a camera (endoscope) to locate and remove stones or debris from your bile or pancreatic duct. It's a non-surgical method to clear the ducts, enhancing your digestive health.

28 services28 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

28 services27 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

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.

26 services26 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

25 services24 patients

Insertion of stent into pancreatic or bile duct using a flexible endoscope 43274

This procedure involves the placement of a tiny tube, known as a stent, into your pancreatic or bile duct. A flexible endoscope, a long, thin instrument with a light and camera, is used. It aids in relieving blockages and improving flow in these ducts.

21 services16 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

20 services20 patients

Ultrasound guided needle aspiration or biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43242

This procedure involves using an ultrasound to guide a needle to specific areas in the esophagus, stomach, or upper small bowel. A flexible endoscope is used to reach these areas. The needle collects a small sample for testing.

19 services19 patients

Removal of large bowel tissue using a flexible endoscope 45390

This procedure, known as a colonoscopy, involves using a flexible endoscope to examine and potentially remove tissue from the large intestine. The endoscope allows the doctor to view the bowel lining directly and remove any abnormal tissue for further analysis.

19 services19 patients

Incision of pancreatic outlet using a flexible endoscope 43262

This procedure involves a small cut in the outlet of the pancreas using a flexible tube with a camera, called an endoscope. It helps doctors diagnose and treat conditions affecting the pancreas, enhancing patient comfort and recovery.

18 services18 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

13 services13 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

12 services12 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

11 services11 patients

Hospital Affiliations CMS Care Compare 4

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

Schuylkill Medical Center - South Jackson Street

Acute Care Hospitals · Pottsville, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390030

Location420 South Jackson StreetPottsville, PA 17901 · Schuylkill County

Emergency services Birthing friendly

Lehigh Valley Hospital

Acute Care Hospitals · Allentown, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390133

Location1200 South Cedar Crest BoulevardAllentown, PA 18103 · Lehigh County

Emergency services Birthing friendly

Lehigh Valley Hospital - Hazleton

Acute Care Hospitals · Hazleton, PA

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number390185

Location700 East Broad StreetHazleton, PA 18201 · Luzerne County

Emergency services Birthing friendly

Lehigh Valley Hospital - Pocono

Acute Care Hospitals · East Stroudsburg, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390201

Location206 East Brown StreetEast Stroudsburg, PA 18301 · Monroe County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18104 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

$126.34 typical visit price

range $54.64 – $166.87

Typical copayment $31.58 (range $13.66 – $41.71)

Most-billed visit code 99204

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

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.

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 Hiral Shah's NPI number?

The NPI number for Hiral Shah is 1093862666. It was assigned to this individual provider in the NPPES registry on January 4, 2007.

Where is Hiral Shah located?

Hiral Shah practices at 1501 N Cedarcrest Blvd Suite 110 Epgi & Liver Specialists, Allentown, PA 18104. The listed phone number is (610) 821-2828.

What is Hiral Shah's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Hiral Shah enrolled in Medicare?

Yes. Hiral 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.

Which organizations bill Medicare for Hiral Shah's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Hiral Shah reassigns Medicare benefits to 5 organizations: Eastern Pennsylvania Gastroenterology & Liver Specialists P C (Allentown, PA), Lehigh Valley Physician Group (Allentown, PA), Via Affiliates (Doylestown, PA), Family Care Centers Inc (East Stroudsburg, PA) and Integrated Medical Group P C (Pottsville, PA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Hiral Shah's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Hiral Shah accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Hiral 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 Hiral Shah affiliated with any hospitals?

According to CMS data, Hiral Shah is affiliated with Schuylkill Medical Center - South Jackson Street, Lehigh Valley Hospital, Lehigh Valley Hospital - Hazleton and Lehigh Valley Hospital - Pocono.

When was this NPI record last updated?

The NPPES record for Hiral Shah was last updated on May 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.