SAMIR N SHAH M.D.
NPI 1205197480
Anesthesiology in Somerset, NJ


Quality Rating: 70.25 out of 100 score

NPI Status: Active since June 04, 2012

Contact Information

285 DAVIDSON AVE STE 204
SOMERSET, NJ
ZIP 08873
Phone: (732) 271-1400
Fax: (732) 271-3544

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  • Individual
  • Male
  • Years of Experience 12
  • Anesthesiology
  • PECOS Enrolled
  • Accepts Medicare Approved Payment

About SAMIR SHAH

Samir Shah is an anesthesiologist established in Somerset, New Jersey and his medical specialization is Anesthesiology with more than 12 years of experience. The healthcare provider is registered in the NPI registry with number 1205197480 assigned on June 2012. The practitioner's primary taxonomy code is 207L00000X with license number 25MA09843100 (NJ). The provider is registered as an individual and his NPI record was last updated 6 years ago.

NPI
1205197480
Provider Name
SAMIR N SHAH M.D.
Gender
Male
Entity Type
Individual
Location Address
285 DAVIDSON AVE STE 204 SOMERSET, NJ 08873
Location Phone
(732) 271-1400
Location Fax
(732) 271-3544
Mailing Address
285 DAVIDSON AVE STE 204 SOMERSET, NJ 08873
Mailing Phone
(732) 271-1400
Mailing Fax
(732) 271-3544
Medical School Name
OTHER
Graduation Year
2012
Is Sole Proprietor?
No
Enumeration Date
06-04-2012
Last Update Date
02-12-2018
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An anesthesiologist like Samir Shah manages the care of surgical patients and pain relief through drug administration that reduces or eliminates pain during an operation, medical procedure or during labor and delivery of babies. During surgical procedures anesthesiologists are responsible for adjusting the amount of anesthetic, monitoring the patient's heart rate, body temperature, blood pressure and breathing.

Samir Shah is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 70.25, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Anesthesiology

Taxonomy Code
207L00000X
Type
Allopathic & Osteopathic Physicians
License No.
25MA09843100
License State
NJ
Taxonomy Description
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.

PECOS Enrollment and Medicare Participation Status

Samir Shah is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 2264726488

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20160811001134

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 70.25 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: N/A

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: 65

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Clinician Services

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 33

    Anesthesia for lens surgery (HCPCS:00142)

  • 22

    Anesthesia for procedure on esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:00731)

Hospital Affiliations

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Samir Shah is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
HACKENSACK UNIVERSITY MEDICAL CENTER30 PROSPECT AVE
HACKENSACK, NJ 7601
(551) 996-2000Acute Care Hospitals
MORRISTOWN MEDICAL CENTER100 MADISON AVE
MORRISTOWN, NJ 7960
(973) 971-5000Acute Care Hospitals
NEWTON MEDICAL CENTER175 HIGH ST
NEWTON, NJ 7860
(973) 383-2121Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1205197480
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
22052914416
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 0 + 5 + 2 + 9 + 1 + 4 + 4 + 1 + 6 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1205197480 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 12 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1689928749 MARGARET A LIDDY C.R.N.A.
Individual
Nurse Anesthetist, Certified Registered285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1992064778 ALAN WILFRED ROMERO CACES MD
Individual
Anesthesiology285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1649448317DR. SAMIR NATAVAR PATEL M.D.
Individual
Anesthesiology285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1427347897 BRETT JOSEPH MOSES M.D.
Individual
Anesthesiology (Pediatric Anesthesiology)285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1003011065DR. LAURA LEI MD
Individual
Anesthesiology285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1871799015DR. STEPHANIE JEAN-NOEL M.D.
Individual
Anesthesiology285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1417156381DR. KRISTA R RUEDY M.D.
Individual
Anesthesiology285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1851538441DR. ERIC LEE M.D.
Individual
Anesthesiology (Pediatric Anesthesiology)285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1144226093 JOHN E KRESGE CRNA
Individual
Nurse Anesthetist, Certified Registered285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1114001211DR. ANILCHANDRA I. BHAGAT M.D.
Individual
Anesthesiology285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1588084974 BHARATH KUMAR MITTAPALLI M.D.
Individual
Anesthesiology285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400
1972263044SPECIALIZED ANESTHESIA SERVICES
Organization
Anesthesiology285 DAVIDSON AVE STE 204
SOMERSET, NJ 08873
(732) 271-1400

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1205197480, enumerated in the NPI registry as an "individual" on June 04, 2012

The provider is located at 285 Davidson Ave Ste 204 Somerset, Nj 08873 and the phone number is (732) 271-1400

The provider's speciality is Anesthesiology with taxonomy code 207L00000X

The provider has more than 12 years of experience.

Yes, as of June 14, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The most common procedures or services performed by this practitioner are: Anesthesia for lens surgery and Anesthesia for procedure on esophagus, stomach, and/or upper small bowel using an endoscope.

The practitioner is affiliated to the following hospital(s): HACKENSACK UNIVERSITY MEDICAL CENTER, MORRISTOWN MEDICAL CENTER and NEWTON MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on June 04, 2012. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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