DR. KETUL K SHAH MD
NPI 1265630230
Urology in Westerville, OH

Q: What is Ketul Shah's NPI number?

The NPI number for Ketul Shah is 1265630230. It was assigned to this individual provider in the NPPES registry on July 11, 2007.

Q: What is Ketul Shah's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Ketul Shah was last updated on January 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since July 11, 2007PECOS EnrolledAccepts Medicare Assignment

87.65/100

CMS Quality Rating

300 POLARIS PKWY STE 2300, WESTERVILLE, OH 43082(614) 788-2870(614) 533-0177 Get Directions Write a Review

NPPES record last updated: January 25, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 25, 2022, Dec 13, 2017 (2 updates tracked since 2017).

On this page

About Dr. Ketul K Shah Md NPPES

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

DR. KETUL K SHAH MD (NPI 1265630230) is an individual urology provider in Westerville, Ohio, licensed in Ohio (35121117) and active in the NPI registry since July 2007. He is enrolled in Medicare PECOS, is affiliated with Riverside Methodist Hospital, and is a graduate of Other (1997).

NPPES Registry Identity

NPI1265630230

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameDR. KETUL K SHAHCredential: MD

Location Address300 POLARIS PKWY STE 2300Westerville, OH 43082-7993

Mailing Address5400 Frantz Rd Ste 250Dublin, OH 43016-6102

Phone(614) 788-2870

Fax(614) 533-0177

Sole ProprietorNo

Medical School CMSOtherGraduated 1997

Enumeration DateJuly 11, 2007

Last NPPES UpdateJanuary 25, 20222 updates tracked since enumeration

✔ NPI 1265630230 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in OH · 35121117

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

300 POLARIS PKWY STE 2300, Westerville, OH 43082

Open in Google Maps ↗

Other Identifiers 1

Medicaid0085240OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, MedMutual.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Ketul K 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 ID9234385485

PECOS Enrollment IDI20130708000619

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.

Medicare Billing Reassignments

Medicare enrollment records show Ketul Shah reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ohiohealth Corporation

9.2 mi

Cardiovascular Disease

3705 OLENTANGY RIVER RD, SUITE 100
Columbus, OH 43214

Reassigned Medicare billing, Ohio enrollment
3,314 clinicians in this Medicare group

NPI 1194979526 (614) 262-6772

Marion Area Physicians LLC

31 mi

Internal Medicine

1040 DELAWARE AVE
Marion, OH 43302

Reassigned Medicare billing, Ohio enrollment
423 clinicians in this Medicare group

NPI 1619230802 (740) 383-7000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 15

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.

Injection, onabotulinumtoxina, 1 unit J0585

Onabotulinumtoxina, also known as Botox, is a medication injected into muscles. It's used to treat various conditions by blocking nerve activity in the muscles, causing a temporary reduction in muscle activity. The units refer to the dosage.

3,300 services14 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

293 services213 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.

216 services173 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.

186 services147 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

63 services57 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.

52 services52 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

46 services43 patients

Complex measurement of pressure of urine flow in bladder with voiding pressure studies 51728

This procedure measures the pressure in your bladder as it fills and empties. It helps to understand how well your bladder is functioning. Sensors record pressure levels during these processes, providing valuable data for your doctor.

29 services29 patients

Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings 51784

This procedure involves the use of non-invasive devices to record the electrical activity of muscles at specific body openings. It's helpful in understanding muscle function and can assist in diagnosing certain conditions.

29 services29 patients

Insertion of device into abdomen with pressure and urine flow rate study 51797

This procedure involves placing a small device into your abdomen to monitor pressure and urine flow rates. It helps in understanding how well your body is processing and eliminating liquid waste. It's a safe procedure, typically performed under local anesthesia.

29 services29 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

27 services27 patients

Exam with injections of chemical for destruction of bladder using an endoscope 52287

This procedure involves the use of a thin, flexible tube with a light (endoscope) for internal examination. A chemical is then injected to help eliminate specific issues in the bladder. It's a standard and safe process.

25 services16 patients

Electronic assessment of bladder emptying 51741

Electronic assessment of bladder emptying is a non-invasive test that measures how well your bladder functions. It uses ultrasound technology to create images of your bladder before and after you use the restroom, helping to identify any issues with bladder emptying.

24 services24 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.

21 services19 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

11 services11 patients

Hospital Affiliations CMS Care Compare 4

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

Riverside Methodist Hospital

Acute Care Hospitals · Columbus, OH

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360006

Location3535 Olentangy River RdColumbus, OH 43214 · Franklin County

Emergency services Birthing friendly

Marion General Hospital

Acute Care Hospitals · Marion, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360011

Location1000 Mckinley Park DriveMarion, OH 43302 · Marion County

Emergency services Birthing friendly

Doctors Hospital

Acute Care Hospitals · Columbus, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number360152

Location5100 West Broad StreetColumbus, OH 43228 · Franklin County

Emergency services Birthing friendly

Dublin Methodist Hospital

Acute Care Hospitals · Dublin, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360348

Location7500 Hospital AvenueDublin, OH 43016 · Franklin County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43082 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

$126.12 typical visit price

range $54.34 – $166.65

Typical copayment $31.53 (range $13.58 – $41.66)

Most-billed visit code 99204

Established Patient

$68.07 typical visit price

range $17.10 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

Most-billed visit code 99213

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.

87.65/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

74.45

Promoting Interoperability

96.03

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 3

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

Lubricant, individual sterile packet, each A4332

DME-Medical/Surgical Supplies · category DA000N

4 suppliers44 claims5,760 services$0.09 avg. paid by Medicare

Indwelling catheter, foley type, two-way, all silicone, each A4344

DME-Orthotic Devices · category DF000N

1 supplier11 claims11 services$14.14 avg. paid by Medicare

Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each A4351

DME-Orthotic Devices · category DF008N

7 suppliers75 claims13,870 services$1.53 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

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

DR. JOHN ALEX BROCKMAN M.D.

Urology

300 POLARIS PKWY STE 2300
WESTERVILLE, OH 43082

Delaware County (614) 533-3034

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 Ketul Shah's NPI number?

The NPI number for Ketul Shah is 1265630230. It was assigned to this individual provider in the NPPES registry on July 11, 2007.

Where is Ketul Shah located?

Ketul Shah practices at 300 Polaris Pkwy Ste 2300, Westerville, OH 43082. The listed phone number is (614) 788-2870.

What is Ketul Shah's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Is Ketul Shah enrolled in Medicare?

Yes. Ketul 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.

Which organizations bill Medicare for Ketul Shah's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ketul Shah reassigns Medicare benefits to 2 organizations: Ohiohealth Corporation (Columbus, OH) and Marion Area Physicians LLC (Marion, OH). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ketul Shah's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ketul Shah accept?

Health plans from Anthem Blue Cross and Blue Shield and MedMutual list Ketul 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 Ketul Shah affiliated with any hospitals?

According to CMS data, Ketul Shah is affiliated with Riverside Methodist Hospital, Marion General Hospital, Doctors Hospital and Dublin Methodist Hospital.

When was this NPI record last updated?

The NPPES record for Ketul Shah was last updated on January 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.