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SONYA SHAH MD
NPI 1295276467
Internal Medicine in Perth Amboy, NJ

Active since March 20, 2017PECOS EnrolledAccepts Medicare Assignment
91.25/100
CMS Quality Rating
530 NEW BRUNSWICK AVE, PERTH AMBOY, NJ 08861(324) 423-7007(948) 243-8064 Get Directions Write a Review

NPPES record last updated: April 1, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 1, 2025, Jun 9, 2020, Mar 20, 2017 (3 updates tracked since 2017).

About Sonya Shah Md NPPES

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

SONYA SHAH MD (NPI 1295276467) is an individual internal medicine provider in Perth Amboy, New Jersey, licensed in New Jersey (25MA11919400) and active in the NPI registry since March 2017. She is enrolled in Medicare PECOS, is affiliated with Jfk Medical Center, and maintains a secondary practice location in Perth Amboy.

NPPES Registry Identity

NPI1295276467
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameSONYA SHAHCredential: MD
Location Address530 NEW BRUNSWICK AVEPerth Amboy, NJ 08861-3654
Mailing Address530 New Brunswick AvePerth Amboy, NJ 08861-3654 · (732) 925-8895 · Fax (948) 243-8064
Phone(324) 423-7007
Fax(948) 243-8064
Sole ProprietorYes
Medical School CMSDrexel University College Of MedicineGraduated 2017
Enumeration DateMarch 20, 2017
Last NPPES UpdateApril 1, 20253 updates tracked since enumeration
NPPES CertifiedApril 1, 2025
✔ NPI 1295276467 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in NJ · 25MA11919400✔ Licensed in NY · 30491201
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
530 NEW BRUNSWICK AVE, Perth Amboy, NJ 08861
Open in Google Maps ↗

Secondary Practice Location 1

Location 1275 Hobart StPerth Amboy, NJ 08861-3396 · Phone (732) 376-9333 · Fax (732) 979-2415

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include 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

Sonya 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 ID6305184482
PECOS Enrollment IDI20240213000451
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 4

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.

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.
67 services29 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
34 services34 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.
32 services31 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
32 services13 patients

Hospital Affiliations CMS Care Compare

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

Jfk Medical Center

Acute Care Hospitals · Edison, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310108
Location65 James StreetEdison, NJ 08820 · Middlesex County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08861 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
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
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.

91.25/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality74.92
Promoting Interoperability91.67
Improvement Activities40

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.

DR. PARUL PRAVINCHANDRA LAKHLANI M.D.
Anesthesiology
530 NEW BRUNSWICK AVE, DIVISION OF ANESTHESIOLOGY, RARITAN BAY MEDICAL CENTER
PERTH AMBOY, NJ 08861
Middlesex County (732) 442-3700
CARDIOLOGY PROFESSIONAL SERVICES AT RARITAN BAY INC
Internal Medicine (Cardiovascular Disease)
530 NEW BRUNSWICK AVE
PERTH AMBOY, NJ 08861
Middlesex County (732) 324-5167
MS. LORRAINE LILLIAN SAUNDERS PA-C
Physician Assistant
530 NEW BRUNSWICK AVE
PERTH AMBOY, NJ 08861
Middlesex County (732) 324-5104
DR. MAHESH H BHAGAT MD
Internal Medicine
530 NEW BRUNSWICK AVE
PERTH AMBOY, NJ 08861
Middlesex County (732) 442-3700
RESHMA ATUL SAKARIA PA
Physician Assistant
530 NEW BRUNSWICK AVE
PERTH AMBOY, NJ 08861
Middlesex County (732) 324-5075
DR. LESLIE POOSER OSEI-TUTU MD
Anesthesiology
530 NEW BRUNSWICK AVE
PERTH AMBOY, NJ 08861
Middlesex County (732) 324-5075
ASFANDYAR IBRAR MD
Student in an Organized Health Care Education/Training Program
530 NEW BRUNSWICK AVE
PERTH AMBOY, NJ 08861
Middlesex County (732) 324-5080
MICHELLE ABRAMOVA DO
Student in an Organized Health Care Education/Training Program
530 NEW BRUNSWICK AVE
PERTH AMBOY, NJ 08861
Middlesex County (732) 442-3700

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 Sonya Shah's NPI number?

The NPI number for Sonya Shah is 1295276467. It was assigned to this individual provider in the NPPES registry on March 20, 2017.

Where is Sonya Shah located?

Sonya Shah practices at 530 New Brunswick Ave, Perth Amboy, NJ 08861. The listed phone number is (324) 423-7007.

What is Sonya Shah's specialty?

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

Is Sonya Shah enrolled in Medicare?

Yes. Sonya 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 Sonya Shah accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Sonya 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 Sonya Shah affiliated with any hospitals?

According to CMS data, Sonya Shah is affiliated with Jfk Medical Center.

When was this NPI record last updated?

The NPPES record for Sonya Shah was last updated on April 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.