MUKUND K SHAH M.D.
Accepted Insurance for NPI 1194829721
Internal Medicine - Hematology & Oncology in Marietta, OH

Q: What managed care network types are accepted by this provider?

MUKUND K SHAH M.D. is enrolled across the following managed care network types: HMO, PPO. HMO (Health Maintenance Organization): Requires receiving care through the network of clinicians and facilities, often requiring primary doctor referrals to access specialist treatments.PPO (Preferred Provider Organization): Provides flexibility to visit out-of-network clinicians without requiring referrals, though seeking care with in-network providers offers lower out-of-pocket costs.

Quality Rating: 94.1 out of 100 score

NPI Status: Active since September 12, 2006

Contact Information

400 MATTHEW ST
STRECKER CANCER CENTER
MARIETTA, OH
ZIP 45750
Phone: (740) 376-5000
Fax: (740) 376-5002

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Accepted Health Plans and Insurance Coverage

This registry outlines the health plan networks and insurance coverage profiles associated with MUKUND K SHAH M.D., a practicing internal medicine professional in Marietta, OH. Compiled from official Health Insurance Marketplace public data and sources from participating insurance companies for the current plan year, this interface is designed to help you determine if your policy is accepted at this practice location. Currently, the provider is listed across 69 individual coverage options managed by medical networks, including networks like Anthem Blue Cross and Blue Shield, CareSource, and Highmark Blue Cross Blue Shield West Virginia. Please use the filtering dashboard below to search for your specific plan by name, narrow results by a single carrier corporate network, or toggle between plan types (HMO, PPO, EPO) to check your status before coordinating an upcoming clinic visit.

Verify before you schedule: insurance networks change throughout the plan year. Confirm coverage directly with your insurance company or this practice’s billing office before booking an appointment.

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Anthem Blue Cross and Blue Shield

Anthem Bronze Pathway 10600 ($0 Virtual PCP + $0 Select Drugs)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

29276OH0970001

Anthem Bronze Pathway 10600 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

29276OH0970010

Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

29276OH0970007

Anthem Bronze Pathway 8500 for HSA

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

29276OH0970012

Anthem Gold Pathway 2000 Standard ($0 Virtual PCP + $0 Select Drugs)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

29276OH0970009

Anthem Heart Healthy Bronze Pathway 6000 ($0 Virtual PCP + $0 Select Drugs)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

29276OH0970002

Anthem Heart Healthy Silver Pathway 5000 ($0 Virtual PCP + $0 Select Drugs)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

29276OH0970006

Anthem Silver Pathway 4000 ($0 Virtual PCP + $0 Select Drugs)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

29276OH0970005

Anthem Silver Pathway 4000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

29276OH0970011

Anthem Silver Pathway 5500 for HSA

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

29276OH0970004

Anthem Silver Pathway 6000 Standard ($0 Virtual PCP + $0 Select Drugs)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

29276OH0970008

CareSource

Bronze 7500 $25 Generic Drugs

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV001002477552OH0010204

Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV002002477552OH0020204

Core Gold 1500 $10 Generic Drugs

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

77552OH0010212

Core Gold 1500 $10 Generic Drugs + Adult Vision & Fitness

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

77552OH0020212

Diabetes Gold 3000 $0 Chronic Care Drugs & Services

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV001003277552OH0010210

Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV002003277552OH0020210

Diabetes Silver 5000 $0 Chronic Care Drugs & Services

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV001003177552OH0010209

Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV002003177552OH0020209

Gold 2000 $15 Generic Drugs

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV001002277552OH0010202

Gold 2000 $15 Generic Drugs + Adult Vision & Fitness

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV002002277552OH0020202

HDHP Preventive Silver 5500 $0 Chronic Care Drugs

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

77552OH0010219

Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV001003577552OH0010215

Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV002003577552OH0020215

Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV001003677552OH0010218

Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV002003677552OH0020218

Low Deductible Silver 5000 $3 Generic Drugs

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV0010025

Low Deductible Silver 5000 $3 Generic Drugs + Adult Vision & Fitness

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV0020025

Low Premium Bronze 10600 $25 Generic Drugs

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV001003877552OH0010222

Low Premium Bronze 10600 $25 Generic Drugs + Adult Vision & Fitness

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV002003877552OH0020222

Low Premium Silver 6200 $3 Generic Drugs

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV001002177552OH0010201

Low Premium Silver 6200 $3 Generic Drugs + Adult Vision & Fitness

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV002002177552OH0020201

Platinum Zero $5 Generic Drugs

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV0010034

Platinum Zero $5 Generic Drugs + Adult Vision & Fitness

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV0020034

Silver 6000 $20 Generic Drugs

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV001002377552OH0010203

Silver 6000 $20 Generic Drugs + Adult Vision & Fitness

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PREFERRED Tier

Accepted Plan ID Variations

50328WV002002377552OH0020203

Highmark Blue Cross Blue Shield West Virginia

my Blue Access WV Major Events PPO Catastrophic 10600 - 3 Free PCP Visits

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: IN-NETWORK Tier

Accepted Plan ID Variations

31274WV0560010

my Blue Access WV PPO Bronze 3800

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: IN-NETWORK Tier

Accepted Plan ID Variations

31274WV0560001

my Blue Access WV PPO Bronze 3800 + Adult Dental and Vision

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: IN-NETWORK Tier

Accepted Plan ID Variations

31274WV0570001

my Blue Access WV PPO Bronze 9200

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: IN-NETWORK Tier

Accepted Plan ID Variations

31274WV0560006

my Blue Access WV PPO Gold 0

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: IN-NETWORK Tier

Accepted Plan ID Variations

31274WV0560005

my Blue Access WV PPO Gold 0 + Adult Dental and Vision

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: IN-NETWORK Tier

Accepted Plan ID Variations

31274WV0570003

my Blue Access WV PPO Gold 1700 HSA

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: IN-NETWORK Tier

Accepted Plan ID Variations

31274WV0580002

my Blue Access WV PPO Premier Gold 0

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: IN-NETWORK Tier

Accepted Plan ID Variations

31274WV0590002

my Blue Access WV PPO Premier Gold 0 + Adult Dental and Vision

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: IN-NETWORK Tier

Accepted Plan ID Variations

31274WV0600002

my Blue Access WV PPO Premier Silver 0

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: IN-NETWORK Tier

Accepted Plan ID Variations

31274WV0590003

my Blue Access WV PPO Premier Silver 0 + Adult Dental and Vision

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: IN-NETWORK Tier

Accepted Plan ID Variations

31274WV0600003

my Blue Access WV PPO Standard Bronze 7500

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: IN-NETWORK Tier

Accepted Plan ID Variations

31274WV0560007

my Blue Access WV PPO Standard Gold 2000

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: IN-NETWORK Tier

Accepted Plan ID Variations

31274WV0560009

my Blue Access WV PPO Standard Gold 2000 + Adult Dental and Vision

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: IN-NETWORK Tier

Accepted Plan ID Variations

31274WV0630002

my Blue Access WV PPO Standard Silver 6000

PPO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: IN-NETWORK Tier

Accepted Plan ID Variations

31274WV0560008

No coverage plans found coordinating with your query criteria.

Coverage Information & FAQs

What insurance does MUKUND K SHAH M.D. accept?

This provider accepts health insurance plans managed by the following insurance companies: Anthem Blue Cross and Blue Shield, CareSource, Highmark Blue Cross Blue Shield West Virginia. You can filter specific policies or search for unique plans using the open dashboard controls located above.

Is this provider enrolled to accept Medicare?

Yes, registry files confirm this provider accepts Medicare assignment, meaning they agree to accept the Medicare-approved amount as full payment for covered services. Additionally, the provider is officially enrolled in the PECOS program (Provider Enrollment, Chain, and Ownership System), verifying that they are certified to order, refer, or prescribe services to Medicare beneficiaries.

What managed care network types are accepted by this provider?

MUKUND K SHAH M.D. is enrolled across the following managed care network types: HMO, PPO.

HMO (Health Maintenance Organization): Requires receiving care through the network of clinicians and facilities, often requiring primary doctor referrals to access specialist treatments.
PPO (Preferred Provider Organization): Provides flexibility to visit out-of-network clinicians without requiring referrals, though seeking care with in-network providers offers lower out-of-pocket costs.

Where does this insurance data come from and how current is it?

The accepted plan information on this page is compiled from official Health Insurance Marketplace public data and insurance companies sources for the current plan year, and it is refreshed as updated files are published. Because insurance networks change frequently throughout the year, always verify coverage directly with the insurance company or the provider’s office before scheduling care.