DR. NILESH M. SHETH M.D., MPH
NPI 1285711705
Ophthalmology in Stoneham, MA

Q: What is Nilesh Sheth's NPI number?

The NPI number for Nilesh Sheth is 1285711705. It was assigned to this individual provider in the NPPES registry on November 1, 2006.

Q: What is Nilesh Sheth's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Q: When was this NPI record last updated?

The NPPES record for Nilesh Sheth was last updated on September 25, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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 November 01, 2006PECOS EnrolledAccepts Medicare Assignment

87.9/100

CMS Quality Rating

3 WOODLAND RD, SUITE 120, STONEHAM, MA 02180(781) 979-0960(781) 979-0618 Get Directions Write a Review

NPPES record last updated: September 25, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Nilesh M. Sheth M.d., Mph NPPES

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

DR. NILESH M. SHETH M.D., MPH (NPI 1285711705) is an individual ophthalmology provider in Stoneham, Massachusetts, licensed in Massachusetts (218562) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS and is a graduate of Wayne State University School Of Medicine (1996).

NPPES Registry Identity

NPI1285711705

Entity TypeIndividualMale

Primary Taxonomy207W00000X

Provider Legal NameDR. NILESH M. SHETHCredential: M.D., MPH

Location Address3 WOODLAND RD, SUITE 120Stoneham, MA 02180-1702

Mailing Address3 Woodland Rd, Suite 120Stoneham, MA 02180-1702 · (781) 979-0960 · Fax (781) 979-0618

Phone(781) 979-0960

Fax(781) 979-0618

Sole ProprietorNo

Medical School CMSWayne State University School Of MedicineGraduated 1996

Enumeration DateNovember 1, 2006

Last NPPES UpdateSeptember 25, 2012

✔ NPI 1285711705 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in MA · 218562

Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

3 WOODLAND RD, Stoneham, MA 02180

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Other Identifiers 5

Medicare UPINH96247

Medicare PIN000301301MA

Medicare ID-Type UnspecifiedOM28830MI

Medicaid4673750MI

Medicare ID-Type UnspecifiedOM28830008MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma 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. Nilesh M. Sheth M.d., Mph 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 ID4183520539

PECOS Enrollment IDI20070420000209

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 13

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 problem focused exam of visual system 92012

This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.

332 services175 patients

Established patient complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

263 services254 patients

Photography of the retina 92250

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

171 services164 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

138 services127 patients

Removal of cataract with insertion of prosthetic lens 66984

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

112 services75 patients

Extended exam involving color vision testing 92283

An extended exam involving color vision testing helps identify any difficulties in distinguishing colors, often due to genetic conditions or health problems. This non-invasive test involves identifying different colored numbers or patterns.

89 services87 patients

Exam of visual field with extended testing 92083

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

81 services79 patients

Imaging of optic nerve 92133

Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).

78 services78 patients

Measurement of corneal curvature and depth of eye 92136

This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.

73 services73 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.

65 services55 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.

49 services49 patients

Placement of amniotic membrane on eye surface for wound healing 65778

The placement of an amniotic membrane on the eye surface is a treatment to promote healing of eye wounds. It involves placing a thin, protective layer over the eye. This layer, derived from the amniotic membrane, helps reduce inflammation and scarring, while encouraging healing.

21 services12 patients

Removal of cataract with insertion of prosthetic lens 66984

13 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02180 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

$144.11 typical visit price

range $63.72 – $189.86

Typical copayment $36.02 (range $15.93 – $47.46)

Most-billed visit code 99204

Established Patient

$78.84 typical visit price

range $21.07 – $155.29

Typical copayment $19.71 (range $5.26 – $38.82)

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.

87.9/100

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

Scored as part of a group practice

Quality

100

Improvement Activities

Cost

57.14

Reported Quality Measures

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

100%54 patients5/55-star benchmark: 100%

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.

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.

ARTHUR TONG, MD

Clinic/Center (Medical Specialty)

3 WOODLAND RD, SUITE 301
STONEHAM, MA 02180

Middlesex County (781) 662-2066

MARY ELLEN DELGER PA

Physician Assistant (Medical)

3 WOODLAND RD, SUITE 216
STONEHAM, MA 02180

Middlesex County (781) 979-0661

WINCHESTER PHYSICIAN ASSOCIATES

Internal Medicine

3 WOODLAND RD, 213
STONEHAM, MA 02180

Middlesex County (781) 662-7990

CLEAR VISION EYE CENTER,INC

Ophthalmology

3 WOODLAND RD, SUITE 120
STONEHAM, MA 02180

Middlesex County (781) 979-0960

DR. MEGAN ROSEMARY WHELTON M.D.

Internal Medicine (Interventional Cardiology)

3 WOODLAND RD, SUITE 421
STONEHAM, MA 02180

Middlesex County (781) 979-8000

ZHIYU ZHANG ACUPUNCTURIST

Acupuncturist

3 WOODLAND RD
STONEHAM, MA 02180

Middlesex County (617) 960-7363

DR. ALICIA B. LAYUG M.D.

Anesthesiology

3 WOODLAND RD, SUITE 322
STONEHAM, MA 02180

Middlesex County (781) 662-2243

HORSLEY EYE CENTER

Ophthalmology

3 WOODLAND RD, SUITE 120
STONEHAM, MA 02180

Middlesex County (781) 979-0960

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 Nilesh Sheth's NPI number?

The NPI number for Nilesh Sheth is 1285711705. It was assigned to this individual provider in the NPPES registry on November 1, 2006.

Where is Nilesh Sheth located?

Nilesh Sheth practices at 3 Woodland Rd Suite 120, Stoneham, MA 02180. The listed phone number is (781) 979-0960.

What is Nilesh Sheth's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Nilesh Sheth enrolled in Medicare?

Yes. Nilesh Sheth 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 Nilesh Sheth accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Nilesh Sheth 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.

When was this NPI record last updated?

The NPPES record for Nilesh Sheth was last updated on September 25, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.