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DR. SHOAIB ALI M.D.
NPI 1124236211
Internal Medicine - Nephrology in Uniontown, PA

Active since May 20, 2007PECOS EnrolledAccepts Medicare Assignment
160 WAYLAND SMITH DR STE 102, UNIONTOWN, PA 15401(724) 438-3300(724) 438-3366 Get Directions Write a Review

NPPES record last updated: May 20, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 16, 2022, Apr 2, 2021, Oct 24, 2019 (3 updates tracked since 2019).

About Dr. Shoaib Ali M.d. NPPES

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

DR. SHOAIB ALI M.D. (NPI 1124236211) is an individual nephrology provider in Uniontown, Pennsylvania, licensed in Pennsylvania (MD472333) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Uniontown Hospital, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1124236211
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameDR. SHOAIB ALICredential: M.D.
Location Address160 WAYLAND SMITH DR STE 102Uniontown, PA 15401-7500
Mailing Address575 Coal Valley Rd Ste 204Clairton, PA 15025-3724 · (412) 466-2220 · Fax (412) 466-4048
Phone(724) 438-3300
Fax(724) 438-3366
Sole ProprietorNo
Medical School CMSOtherGraduated 2005
Enumeration DateMay 20, 2007
Last NPPES UpdateMay 20, 20243 updates tracked since enumeration
NPPES CertifiedMay 20, 2024
✔ NPI 1124236211 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Licenses✔ Licensed in PA · MD472333✔ Licensed in MD · D68977
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
160 WAYLAND SMITH DR STE 102, Uniontown, PA 15401
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Other Identifiers 2

Medicaid1027622820004PA
Medicaid1038382690011PA

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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Shoaib Ali 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 ID4880745744
PECOS Enrollment IDI20201118000163
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 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
213 services81 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.
186 services102 patients
Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
75 services15 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.
31 services30 patients
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.
27 services18 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.
25 services24 patients

Hospital Affiliations CMS Care Compare 5

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

Uniontown Hospital

Acute Care Hospitals · Uniontown, PA
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390041
Location500 West Berkeley StreetUniontown, PA 15401 · Fayette County
Emergency services

Excela Health Westmoreland Regional Hospital

Acute Care Hospitals · Greensburg, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390145
Location532 West Pittsburgh StreetGreensburg, PA 15601 · Westmoreland County
Emergency services Birthing friendly

Indiana Regional Medical Center

Acute Care Hospitals · Indiana, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390173
Location835 Hospital RoadIndiana, PA 15701 · Indiana County
Emergency services Birthing friendly

Excela Health - Frick Hospital

Acute Care Hospitals · Mount Pleasant, PA
OwnershipVoluntary non-profit - Other
CMS Certification Number390217
Location508 South Church StreetMount Pleasant, PA 15666 · Westmoreland County
Emergency services

Excela Health Latrobe Hospital

Acute Care Hospitals · Latrobe, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390219
LocationOne Mellon WayLatrobe, PA 15650 · Westmoreland County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15401 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.

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.

Reported Quality Measures

Care Plan
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…
89%383 patients4/55-star benchmark: 100%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
98%169 patients4/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
99%957 patients4/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
49%383 patients3/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
16%578 patients1/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
19%516 patients1/55-star benchmark: 88%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients tobacco: 93% · 258 patients
100%258 patients
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 383 patients
0%383 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 3

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

DEMETRIUS PETER RIZOS DO
Internal Medicine (Nephrology)
160 WAYLAND SMITH DR STE 102
UNIONTOWN, PA 15401
Fayette County (724) 438-3300
BRITTNEY M BOEHM FNP
Nurse Practitioner
160 WAYLAND SMITH DR STE 102
UNIONTOWN, PA 15401
Fayette County (724) 438-3300
KELLY L KEEGAN CRNP
Nurse Practitioner
160 WAYLAND SMITH DR STE 102
UNIONTOWN, PA 15401
Fayette County (724) 438-3300

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 Shoaib Ali's NPI number?

The NPI number for Shoaib Ali is 1124236211. It was assigned to this individual provider in the NPPES registry on May 20, 2007.

Where is Shoaib Ali located?

Shoaib Ali practices at 160 Wayland Smith Dr Ste 102, Uniontown, PA 15401. The listed phone number is (724) 438-3300.

What is Shoaib Ali's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Shoaib Ali enrolled in Medicare?

Yes. Shoaib Ali 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 Shoaib Ali accept?

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

According to CMS data, Shoaib Ali is affiliated with Uniontown Hospital, Excela Health Westmoreland Regional Hospital, Indiana Regional Medical Center, Excela Health - Frick Hospital and Excela Health Latrobe Hospital.

When was this NPI record last updated?

The NPPES record for Shoaib Ali was last updated on May 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.