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DR. BHAVESH A. SHAH M.D.
NPI 1255403663
Family Medicine in Sarasota, FL

Active since November 14, 2006PECOS EnrolledAccepts Medicare Assignment
78.8/100
CMS Quality Rating
1921 WALDEMERE ST STE 405, SARASOTA, FL 34239(941) 917-3500(941) 917-3501 Get Directions Write a Review

NPPES record last updated: July 6, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 6, 2020, Apr 28, 2017, Jan 26, 2016 and 1 more (4 updates tracked since 2015).

About Dr. Bhavesh A. Shah M.d. NPPES

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

DR. BHAVESH A. SHAH M.D. (NPI 1255403663) is an individual family medicine provider in Sarasota, Florida, licensed in Florida (ME145449) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS, is affiliated with Sarasota Memorial Hospital, and maintains a secondary practice location in Geneva.

NPPES Registry Identity

NPI1255403663
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. BHAVESH A. SHAHCredential: M.D.
Location Address1921 WALDEMERE ST STE 405Sarasota, FL 34239-2941
Mailing AddressPo Box 863407Orlando, FL 32886-3407 · (941) 917-2600 · Fax (941) 917-7884
Phone(941) 917-3500
Fax(941) 917-3501
Sole ProprietorNo
Medical School CMSUniversity Of Missouri, Kansas City, School Of MedicineGraduated 1997
Enumeration DateNovember 14, 2006
Last NPPES UpdateJuly 6, 20204 updates tracked since enumeration
NPPES CertifiedJuly 6, 2020
✔ NPI 1255403663 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in FL · ME145449✔ Licensed in IL · 036-101053
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.
1921 WALDEMERE ST STE 405, Sarasota, FL 34239
Open in Google Maps ↗

Secondary Practice Location 1

Location 1351 Delnor DrGeneva, IL 60134-4222 · Phone (630) 938-9900 · Fax (630) 938-9930

Other Identifiers 2

Other920540IL · Medicare Ptan Group
OtherF400268164IL · Medicare Ptan Individual

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.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. Bhavesh A. 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 ID9436179504
PECOS Enrollment IDI20200730003438
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 11

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 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.
1,210 services745 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
534 services534 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.
310 services245 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
89 services89 patients
Telephone medical discussion with physician, 11-20 minutes 99442
This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.
81 services69 patients
Transitional care management services for problem of high complexity 99496
Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.
50 services44 patients

Hospital Affiliations CMS Care Compare 2

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

Sarasota Memorial Hospital

Acute Care Hospitals · Sarasota, FL
5/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100087
Location1700 S Tamiami TrlSarasota, FL 34239 · Sarasota County
Emergency services Birthing friendly

Sarasota Memorial Hospital - Venice

Acute Care Hospitals · North Venice, FL
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number100359
Location2600 Laurel Rd ENorth Venice, FL 34275 · Sarasota County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34239 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

78.8/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.37
Promoting Interoperability99
Improvement Activities40
Cost50.81

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.

ETHAN MARSHALL WINDHAM MD
Internal Medicine
1921 WALDEMERE ST STE 405
SARASOTA, FL 34239
Sarasota County (941) 917-3500
SARASOTA COUNTY PUBLIC HOSPITAL DISTRICT
Clinic/Center (Federally Qualified Health Center (FQHC))
1921 WALDEMERE ST STE 405
SARASOTA, FL 34239
Sarasota County (941) 917-3500
DR. JEFFREY ALLEN HUMBARGER M.D.
Internal Medicine
1921 WALDEMERE ST STE 405
SARASOTA, FL 34239
Sarasota County (941) 917-3500

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 Bhavesh Shah's NPI number?

The NPI number for Bhavesh Shah is 1255403663. It was assigned to this individual provider in the NPPES registry on November 14, 2006.

Where is Bhavesh Shah located?

Bhavesh Shah practices at 1921 Waldemere St Ste 405, Sarasota, FL 34239. The listed phone number is (941) 917-3500.

What is Bhavesh Shah's specialty?

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

Is Bhavesh Shah enrolled in Medicare?

Yes. Bhavesh 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 Bhavesh Shah accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 1 other insurer list Bhavesh 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 Bhavesh Shah affiliated with any hospitals?

According to CMS data, Bhavesh Shah is affiliated with Sarasota Memorial Hospital and Sarasota Memorial Hospital - Venice.

When was this NPI record last updated?

The NPPES record for Bhavesh Shah was last updated on July 6, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.