SAIMA SHAFI M.D.
NPI 1285655134
Internal Medicine in Easton, PA

NPI Status: Active since July 23, 2006

Contact Information

2100 LEHIGH ST
EASTON, PA
ZIP 18042
Phone: (610) 253-3551
Fax: (610) 250-1043

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Durable Medical Equipment
Physician Visit Costs
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Years of Experience 28
Internal Medicine
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About SAIMA SHAFI

This page provides the complete NPI Profile along with additional information for Saima Shafi, an internist established in Easton, Pennsylvania with a medical specialization in Internal Medicine and more than 28 years of experience. The healthcare provider is registered in the NPI registry with number 1285655134 assigned on July 2006. The practitioner's primary taxonomy code is 207R00000X with license number MD425178 (PA). The provider is registered as an individual and her NPI record was last updated 18 years ago.

NPI: 1285655134
Provider Name: SAIMA SHAFI M.D.
Gender: Female
Entity Type: Individual
Location Address: 2100 LEHIGH ST EASTON, PA 18042
Location Phone: (610) 253-3551
Location Fax: (610) 250-1043
Mailing Address: 2100 LEHIGH ST EASTON, PA 18042
Mailing Phone: (610) 253-3551
Mailing Fax: (610) 250-1043
Medical School Name: OTHER
Graduation Year: 1998
Is Sole Proprietor?: No
Enumeration Date: 07-23-2006
Last Update Date: 07-17-2007
Code Navigator

An internist like Saima Shafi is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

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: Internal Medicine
Taxonomy Code: 207R00000X
Type: Allopathic & Osteopathic Physicians
License No.: MD425178
License State: PA
Taxonomy Description: 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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Blue Cross Blue Shield

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Highmark Blue Shield

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
I26144	MEDICARE UPIN (02)	PA
1689416	OTHER (01)	PA	HIGHMARK BLUE SHIELD
088711U46	MEDICARE PIN (08)	PA

Medicare Participation & PECOS Enrollment Status

Saima Shafi 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.

Saima Shafi 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: 5496700189
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: I20050315001045
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

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Orthotic Devices

DME-Orthotic Devices (DF000N)
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) (HCPCS:A4314)
1 DME suppliers used 14 Medicare Claims 14 Services Paid
DME-Orthotic Devices (DF000N)
Urinary catheter anchoring device, adhesive skin attachment, each (HCPCS:A4333)
1 DME suppliers used 14 Medicare Claims 100 Services Paid
DME-Orthotic Devices (DF000N)
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each (HCPCS:A4357)
1 DME suppliers used 14 Medicare Claims 14 Services Paid

Durable Medical Equipment

DME-Other DME (DE000N)
Walker, folding, wheeled, adjustable or fixed height (HCPCS:E0143)
1 DME suppliers used 15 Medicare Claims 15 Services Paid
DME-Other DME (DE000N)
Commode chair, mobile or stationary, with fixed arms (HCPCS:E0163)
1 DME suppliers used 18 Medicare Claims 18 Services Paid
DME-Other DME (DE000N)
Gel or gel-like pressure pad for mattress, standard mattress length and width (HCPCS:E0185)
1 DME suppliers used 14 Medicare Claims 14 Services Paid
DME-Hospital Beds (DB000N)
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress (HCPCS:E0260)
2 DME suppliers used 110 Medicare Claims 110 Services Paid
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
3 DME suppliers used 36 Medicare Claims 36 Services Paid
DME-Other DME (DE000N)
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) (HCPCS:E0630)
2 DME suppliers used 17 Medicare Claims 17 Services Paid
DME-Wheelchairs (DD000N)
Heel loop/holder, any type, with or without ankle strap, each (HCPCS:E0951)
2 DME suppliers used 30 Medicare Claims 60 Services Paid
DME-Wheelchairs (DD021N)
Manual wheelchair accessory, wheel lock brake extension (handle), each (HCPCS:E0961)
2 DME suppliers used 29 Medicare Claims 58 Services Paid
DME-Wheelchairs (DD021N)
Manual wheelchair accessory, anti-tipping device, each (HCPCS:E0971)
2 DME suppliers used 31 Medicare Claims 62 Services Paid
DME-Wheelchairs (DD021N)
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each (HCPCS:E0973)
2 DME suppliers used 22 Medicare Claims 44 Services Paid
DME-Other DME (DE000N)
Transport chair, adult size, patient weight capacity up to and including 300 pounds (HCPCS:E1038)
1 DME suppliers used 14 Medicare Claims 14 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
4 DME suppliers used 58 Medicare Claims 58 Services Paid
DME-Wheelchairs (DD021N)
General use wheelchair seat cushion, width less than 22 inches, any depth (HCPCS:E2601)
2 DME suppliers used 30 Medicare Claims 30 Services Paid
DME-Wheelchairs (DD021N)
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware (HCPCS:E2611)
1 DME suppliers used 30 Medicare Claims 30 Services Paid
DME-Wheelchairs (DD000N)
Standard wheelchair (HCPCS:K0001)
3 DME suppliers used 153 Medicare Claims 153 Services Paid
DME-Wheelchairs (DD000N)
Standard hemi (low seat) wheelchair (HCPCS:K0002)
1 DME suppliers used 100 Medicare Claims 100 Services Paid
DME-Wheelchairs (DD000N)
Lightweight wheelchair (HCPCS:K0003)
1 DME suppliers used 117 Medicare Claims 117 Services Paid
DME-Wheelchairs (DD000N)
Heavy duty wheelchair (HCPCS:K0006)
1 DME suppliers used 19 Medicare Claims 19 Services Paid
DME-Wheelchairs (DD021N)
Seat height less than 17" or equal to or greater than 21" for a high strength, lightweight, or ultralightweight wheelchair (HCPCS:K0056)
2 DME suppliers used 18 Medicare Claims 18 Services Paid
DME-Wheelchairs (DD021N)
Elevating leg rests, pair (for use with capped rental wheelchair base) (HCPCS:K0195)
1 DME suppliers used 46 Medicare Claims 46 Services Paid

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient custodial care facility, group care, or assisted living visit, typically 25 minutes
Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes
Follow-up nursing facility visit per day, typically 10 minutes
Follow-up nursing facility visit per day, typically 10 minutes
Follow-up nursing facility visit per day, typically 15 minutes
Follow-up nursing facility visit per day, typically 15 minutes
Follow-up nursing facility visit per day, typically 25 minutes
Follow-up nursing facility visit per day, typically 25 minutes
Follow-up nursing facility visit per day, typically 35 minutes
Initial nursing facility visit per day, typically 35 minutes
Initial nursing facility visit per day, typically 45 minutes
Initial nursing facility visit per day, typically 45 minutes
Nursing facility discharge management, more than 30 minutes
Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.58 for a new patient copayment and $24.2 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 18042 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $126.34
Minimum New Patient Price $54.64
Maximum New Patient Price $166.87

Average New Patient Copayment $31.58
Minimum New Patient Copayment $13.66
Maximum New Patient Copayment $41.71

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $96.82
Minimum Established Patient Price $17.33
Maximum Established Patient Price $135.84

Average Established Patient Copayment $24.2
Minimum Established Patient Copayment $4.33
Maximum Established Patient Copayment $33.96

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
Chronic Care and Preventative Care Management for Empaneled Patients	Yes	N/A
Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation.
Implementation of medication management practice improvements	Yes	N/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Measurement and Improvement at the Practice and Panel Level	Yes	N/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Medication Reconciliation	100%	21
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education	36%	187
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Provide Patient Access	86%	187
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging	69%	187
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Use of decision support and standardized treatment protocols	Yes	N/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

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.
1	2	8	5	6	5	5	1	3	4
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	2	16	5	12	5	10	1	6
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 1 + 6 + 5 + 1 + 2 + 5 + 1 + 0 + 1 + 6 + 24 = 56
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 56 = 4									4

The NPI number 1285655134 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.