Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

PRIYA GULATI SHAH M.D.
NPI 1154716405
Family Medicine in Dawsonville, GA

Active since April 03, 2015PECOS Enrolled
204 DAWSON VILLAGE WAY S, DAWSONVILLE, GA 30534(770) 268-4360(470) 251-6066 Get Directions Write a Review

NPPES record last updated: August 21, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 21, 2026, Aug 7, 2025, Aug 24, 2018 and 2 more (5 updates tracked since 2018).

About Priya Gulati Shah M.d. NPPES

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

PRIYA GULATI SHAH M.D. (NPI 1154716405) is an individual family medicine provider in Dawsonville, Georgia, licensed in Georgia (80374) and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS, is affiliated with Northside Hospital Forsyth, and is a graduate of Wayne State University School Of Medicine (2015).

NPPES Registry Identity

NPI1154716405
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NamePRIYA GULATI SHAHCredential: M.D.
Location Address204 DAWSON VILLAGE WAY SDawsonville, GA 30534-5629
Mailing AddressPo Box 746765Atlanta, GA 30374-6765 · (770) 914-0116 · Fax (770) 955-4278
Fax(470) 251-6066
Sole ProprietorNo
Medical School CMSWayne State University School Of MedicineGraduated 2015
Enumeration DateApril 3, 2015
Last NPPES UpdateAugust 21, 20265 updates tracked since enumeration
NPPES CertifiedAugust 21, 2026
NPI 1154716405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in GA · 80374
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
204 DAWSON VILLAGE WAY S, Dawsonville, GA 30534

Accepted 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

Priya Gulati 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 ID7012210818
PECOS Enrollment IDI20180914002609
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 41

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.

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
539 services71 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
312 services202 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
299 services197 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
293 services197 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.
271 services189 patients
Blood test, lipids (cholesterol and triglycerides) 80061
A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
266 services180 patients

Hospital Affiliations CMS Care Compare 3

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

Northside Hospital Forsyth

Acute Care Hospitals · Cumming, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110005
Location1200 Northside Forsyth DriveCumming, GA 30041 · Forsyth County
Birthing friendly

Piedmont Rockdale Hospital

Acute Care Hospitals · Conyers, GA
2/5 CMS rating
OwnershipProprietary
CMS Certification Number110091
Location1412 Milstead Avenue, NEConyers, GA 30012 · Rockdale County
Birthing friendly

Piedmont Henry Hospital

Acute Care Hospitals · Stockbridge, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110191
Location1133 Eagle's Landing ParkwayStockbridge, GA 30281 · Henry County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30534 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
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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

Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
82%93 patients4/55-star benchmark: 100%
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…
100%106 patients5/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
100%65 patients5/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
100%37 patients5/55-star benchmark: 98%
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.

Referred Medical Equipment & Supplies CMS DME claims 6

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
1 supplier14 claims14 services$30.97 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
3 suppliers12 claims12 services$62.54 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
2 suppliers12 claims33 services$26.37 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
3 suppliers13 claims13 services$11.71 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
2 suppliers19 claims105 services$1.61 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
1 supplier16 claims16 services$29.92 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 7

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

Family Medicine
204 DAWSON VILLAGE WAY S
DAWSONVILLE, GA 30534
Nurse Practitioner (Family)
204 DAWSON VILLAGE WAY S
DAWSONVILLE, GA 30534
Family Medicine
204 DAWSON VILLAGE WAY S
DAWSONVILLE, GA 30534
Physician Assistant
204 DAWSON VILLAGE WAY S
DAWSONVILLE, GA 30534
Nurse Practitioner (Family)
204 DAWSON VILLAGE WAY S
DAWSONVILLE, GA 30534
Family Medicine
204 DAWSON VILLAGE WAY S
DAWSONVILLE, GA 30534
Pharmacy
204 DAWSON VILLAGE WAY S
DAWSONVILLE, GA 30534

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 Priya Shah's NPI number?

The NPI number for Priya Shah is 1154716405. It was assigned to this individual provider in the NPPES registry on April 3, 2015.

Where is Priya Shah located?

Priya Shah practices at 204 Dawson Village Way S, Dawsonville, GA 30534. The listed phone number is (770) 268-4360.

What is Priya Shah's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Priya Shah enrolled in Medicare?

Yes. Priya 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 Priya Shah accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Priya 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 Priya Shah affiliated with any hospitals?

According to CMS data, Priya Shah is affiliated with Northside Hospital Forsyth, Piedmont Rockdale Hospital and Piedmont Henry Hospital.

When was this NPI record last updated?

The NPPES record for Priya Shah was last updated on August 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 days 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.