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SUNIL SHAH D.O.
NPI 1275517211
Internal Medicine in Oak Lawn, IL

Active since December 02, 2005PECOS EnrolledAccepts Medicare AssignmentCLIA 14D1072746 · Waiver
100/100
CMS Quality Rating
4647 W 103RD ST, SUITE 1-I, OAK LAWN, IL 60453(708) 423-7424(708) 423-7428 Get Directions Write a Review

NPPES record last updated: March 25, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Sunil Shah D.o. NPPES

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

SUNIL SHAH D.O. (NPI 1275517211) is an individual internal medicine provider in Oak Lawn, Illinois, licensed in Illinois (036105759) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through June 26, 2027, and is affiliated with Presence St Marys Hospital.

NPPES Registry Identity

NPI1275517211
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameSUNIL SHAHCredential: D.O.
Location Address4647 W 103RD ST, SUITE 1-IOak Lawn, IL 60453-4779
Mailing Address7641 Newfield LnTinley Park, IL 60487-5539 · (708) 423-7424 · Fax (708) 423-7428
Phone(708) 423-7424
Fax(708) 423-7428
Sole ProprietorYes
Medical School CMSMidwestern University, Chicago College Of Osteopathic MedGraduated 1999
Enumeration DateDecember 2, 2005
Last NPPES UpdateMarch 25, 2014
✔ NPI 1275517211 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 036105759
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
4647 W 103RD ST, Oak Lawn, IL 60453
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Other Identifiers 1

Medicare UPINH66887IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.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

Sunil Shah D.o. 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 ID6103816244
PECOS Enrollment IDI20040512001234
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D1072746

Dr Sunil K Shah D O, S C - Oak Lawn · Oak Lawn, IL
Active · expires Jun 26, 2027
CLIA Number14D1072746
Laboratory TypePhysician Office
Certificate Effective DateJune 27, 2025
Certificate Expiration DateJune 26, 2027
Laboratory DirectorSunil K. Shah
Laboratory Phone(708) 423-7424
Laboratory LocationDr Sunil K Shah D O, S C - Oak Lawn4647 W 103rd Street, Suite 1-I, Oak Lawn, IL 60453
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 14

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 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.
469 services178 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.
460 services126 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.
418 services140 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.
318 services190 patients
Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes 99347
An established patient home visit is a service where a healthcare professional visits your home for a 15-minute check-up. It's designed for patients who have previously seen the professional. The visit may include basic health assessments and discussions about your ongoing care.
239 services47 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.
187 services150 patients

Hospital Affiliations CMS Care Compare 4

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

Presence St Marys Hospital

Acute Care Hospitals · Kankakee, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140155
Location500 W Court StKankakee, IL 60901 · Kankakee County
Emergency services Birthing friendly

Riverside Medical Center

Acute Care Hospitals · Kankakee, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140186
Location350 N Wall StKankakee, IL 60901 · Kankakee County
Emergency services Birthing friendly

Advocate Christ Hospital & Medical Center

Acute Care Hospitals · Oak Lawn, IL
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140208
Location4440 W 95th StreetOak Lawn, IL 60453 · Cook County
Emergency services Birthing friendly

Silver Cross Hospital And Medical Centers

Acute Care Hospitals · New Lenox, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140213
Location1900 Silver Cross BlvdNew Lenox, IL 60451 · Will County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60453 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
$138.86 typical visit price
range $60.08 – $183.39
Typical copayment $34.71 (range $15.02 – $45.84)
Most-billed visit code 99204
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality100
Improvement Activities40

Reported Quality Measures

Advance Care Plan
99%466 patients4/55-star benchmark: 100%
Controlling High Blood Pressure
85%766 patients4/55-star benchmark: 98%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
43%305 patients3/55-star benchmark: 98%
Documentation of Current Medications in the Medical Record
100%6,753 patients5/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
100%1,549 patients5/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 82% · 1,415 patients
Patients screened: 98% · 1,415 patients
100%395 patients5/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Patients combinedPopulations: 97% · 1,415 patients
Patients screened: 97% · 1,415 patients
99%104 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 4

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
15 suppliers35 claims113 services$5.59 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
11 suppliers33 claims49 services$0.93 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers19 claims19 services$59.88 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
3 suppliers27 claims27 services$181.93 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 15

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

DR. MICHAEL A KOZEK DDS
Dentist (General Practice)
4647 W 103RD ST, SUITE 2-I
OAK LAWN, IL 60453
Cook County (708) 423-0500
DR. RICHARD JAMES HRAD D.D.S.
Dentist
4647 W 103RD ST, SUITE 1A
OAK LAWN, IL 60453
Cook County (708) 636-1700
DR. GEORGE WILLIAM LINGEN JR. DDS
Dentist (General Practice)
4647 W 103RD ST, SUITE 1M
OAK LAWN, IL 60453
Cook County (708) 424-2150
DERMATOLOGY CENTER ASSOCIATES SC
Dermatology
4647 W 103RD ST
OAK LAWN, IL 60453
Cook County (708) 636-3767
HESHAM K HEGAZY LPT
Physical Therapist
4647 W 103RD ST, STE. #2L
OAK LAWN, IL 60453
Cook County (708) 425-3466
DR. EUGENE CHARLES DECKER DDS
Dentist (General Practice)
4647 W 103RD ST, SUITE #1D
OAK LAWN, IL 60453
Cook County (708) 422-8260
DR. GEOFFREY TODD DECKER DMD
Dentist (General Practice)
4647 W 103RD ST, SUITE #1D
OAK LAWN, IL 60453
Cook County (708) 422-6500
SATINDER PAL SINGH DALAWARI MD
Internal Medicine
4647 W 103RD ST, SUITE 2L
OAK LAWN, IL 60453
Cook County (708) 952-0200

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 Sunil Shah's NPI number?

The NPI number for Sunil Shah is 1275517211. It was assigned to this individual provider in the NPPES registry on December 2, 2005.

Where is Sunil Shah located?

Sunil Shah practices at 4647 W 103rd St Suite 1-I, Oak Lawn, IL 60453. The listed phone number is (708) 423-7424.

What is Sunil Shah's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Sunil Shah enrolled in Medicare?

Yes. Sunil 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.

Does Sunil Shah hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D1072746) is associated with this NPI, valid through June 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Sunil Shah accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Sunil 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 Sunil Shah affiliated with any hospitals?

According to CMS data, Sunil Shah is affiliated with Presence St Marys Hospital, Riverside Medical Center, Advocate Christ Hospital & Medical Center and Silver Cross Hospital And Medical Centers.

When was this NPI record last updated?

The NPPES record for Sunil Shah was last updated on March 25, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.