1. Home
  2. Directory
  3. Wisconsin
  4. Milwaukee
  5. Internal Medicine
  6. NPI Profile

NIRAV N SHAH MD
NPI 1245491257
Internal Medicine - Hematology & Oncology in Milwaukee, WI

Active since June 23, 2008PECOS EnrolledAccepts Medicare Assignment
80.46/100
CMS Quality Rating
9200 W WISCONSIN AVE, NEOPLASIC DISEASES, MILWAUKEE, WI 53226(414) 805-6800(414) 805-6815 Get Directions Write a Review

NPPES record last updated: October 1, 2020. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Nirav N Shah Md NPPES

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

NIRAV N SHAH MD (NPI 1245491257) is an individual hematology & oncology provider in Milwaukee, Wisconsin, licensed in Wisconsin (63993) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS, is affiliated with Community Memorial Hospital, and is a graduate of Chicago College Of Medicine And Surgery (2008).

NPPES Registry Identity

NPI1245491257
Entity TypeIndividualMale
Primary Taxonomy207RH0003X
Provider Legal NameNIRAV N SHAHCredential: MD
Location Address9200 W WISCONSIN AVE, NEOPLASIC DISEASESMilwaukee, WI 53226-3522
Mailing Address9200 W Wisconsin Ave, Neoplasic DiseasesMilwaukee, WI 53226-3522 · (414) 805-6800 · Fax (414) 805-6815
Phone(414) 805-6800
Fax(414) 805-6815
Sole ProprietorNo
Medical School CMSChicago College Of Medicine And SurgeryGraduated 2008
Enumeration DateJune 23, 2008
Last NPPES UpdateOctober 1, 2020
NPPES CertifiedOctober 1, 2020
✔ NPI 1245491257 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Hematology & OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RH0003X
License✔ Licensed in WI · 63993
Definition
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Also ListedInternal MedicineTaxonomy 207R00000X · License MD445171 (PA)
9200 W WISCONSIN AVE, Milwaukee, WI 53226
Open in Google Maps ↗

Other Identifiers 1

Medicaid1245491257WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Network Health.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

Nirav 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 ID143408328
PECOS Enrollment IDI20150826001526
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.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
148 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.
139 services79 patients
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.
54 services19 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.
49 services46 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
23 services23 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.
18 services13 patients

Hospital Affiliations CMS Care Compare 3

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

Community Memorial Hospital

Acute Care Hospitals · Menomonee Falls, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520103
LocationW180 N8085 Town Hall RdMenomonee Falls, WI 53051 · Waukesha County
Emergency services

Holy Family Memorial

Acute Care Hospitals · Manitowoc, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number520107
Location2300 Western AveManitowoc, WI 54221 · Manitowoc County
Emergency services

Froedtert Memorial Lutheran Hospital

Acute Care Hospitals · Milwaukee, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520177
Location9200 W Wisconsin AveMilwaukee, WI 53226 · Milwaukee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53226 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
$163.24 typical visit price
range $53.90 – $163.24
Typical copayment $40.81 (range $13.47 – $40.81)
Most-billed visit code 99205
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

80.46/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality66.24
Promoting Interoperability100
Improvement Activities40
Cost68.64

Referred Medical Equipment & Supplies CMS DME claims

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

Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers12 claims750 services$0.36 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 20

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

TRACY BLAIR WANDTKE HERRMANN APNP, CNM
Advanced Practice Midwife
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-4777
DR. ZACHARY SMITH DO
Internal Medicine (Gastroenterology)
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 955-6830
DR. COLLEEN ANN CROWE M.D., M.P.H.
Emergency Medicine
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-6469
ROBERTO MEJIAS APNP
Nurse Practitioner (Pediatrics)
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-6600
MRS. ANNE E B LAKATOS APN-BC, APNP, RN
Nurse Practitioner (Adult Health)
9200 W WISCONSIN AVE, DEPT OF INTERNAL MEDICINE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-6850
MRS. AMANDA M MANDERS APNP
Nurse Practitioner (Adult Health)
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-6850
KATHLEEN A WATERHOUSE-SKIBICKI CRNA
Nurse Anesthetist, Certified Registered
9200 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 805-5951
ANDREA L BEQUEST PA
Physician Assistant (Medical)
9200 W WISCONSIN AVE, INTERNAL MEDICINE
MILWAUKEE, WI 53226
Milwaukee County (414) 955-0350

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 Nirav Shah's NPI number?

The NPI number for Nirav Shah is 1245491257. It was assigned to this individual provider in the NPPES registry on June 23, 2008.

Where is Nirav Shah located?

Nirav Shah practices at 9200 W Wisconsin Ave Neoplasic Diseases, Milwaukee, WI 53226. The listed phone number is (414) 805-6800.

What is Nirav Shah's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Hematology & Oncology, with taxonomy code 207RH0003X.

Is Nirav Shah enrolled in Medicare?

Yes. Nirav 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 Nirav Shah accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan and Network Health list Nirav 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 Nirav Shah affiliated with any hospitals?

According to CMS data, Nirav Shah is affiliated with Community Memorial Hospital, Holy Family Memorial and Froedtert Memorial Lutheran Hospital.

When was this NPI record last updated?

The NPPES record for Nirav Shah was last updated on October 1, 2020. 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.