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DR. SHAWN C ZETO MD
NPI 1306800040
Internal Medicine in Erie, PA

Active since April 12, 2006PECOS EnrolledAccepts Medicare Assignment
93.78/100
CMS Quality Rating
240 W 11TH ST STE 301, ERIE, PA 16501(814) 480-7770 Get Directions Write a Review

NPPES record last updated: April 10, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 10, 2025, Jul 12, 2024, Dec 4, 2020 and 1 more (4 updates tracked since 2020).

About Dr. Shawn C Zeto Md NPPES

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

DR. SHAWN C ZETO MD (NPI 1306800040) is an individual internal medicine provider in Erie, Pennsylvania, licensed in Pennsylvania (MD422170) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Saint Vincent Hospital, and is a graduate of Pennsylvania State University College Of Medicine (2000).

NPPES Registry Identity

NPI1306800040
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. SHAWN C ZETOCredential: MD
Location Address240 W 11TH ST STE 301Erie, PA 16501-1758
Mailing Address100 Peach St Ste 300Erie, PA 16507-1423 · (814) 459-1851 · Fax (814) 480-7769
Phone(814) 480-7770
Sole ProprietorNo
Medical School CMSPennsylvania State University College Of MedicineGraduated 2000
Enumeration DateApril 12, 2006
Last NPPES UpdateApril 10, 20254 updates tracked since enumeration
NPPES CertifiedApril 10, 2025
✔ NPI 1306800040 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in PA · MD422170
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.
240 W 11TH ST STE 301, Erie, PA 16501
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Other Identifiers 2

Medicaid001965395PA
Other001508797PA · Highmark Bcbs

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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. Shawn C Zeto 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 ID3476443102
PECOS Enrollment IDI20040317000710
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.

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.
620 services47 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.
178 services129 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.
175 services24 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
99 services99 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
74 services74 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
61 services51 patients

Hospital Affiliations CMS Care Compare 3

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

Saint Vincent Hospital

Acute Care Hospitals · Erie, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390009
Location232 West 25th StreetErie, PA 16544 · Erie County
Emergency services Birthing friendly

Upmc Hamot

Acute Care Hospitals · Erie, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390063
Location201 State StreetErie, PA 16550 · Erie County
Emergency services Birthing friendly

Lecom Health Corry Memorial Hospital

Critical Access Hospitals · Corry, PA
OwnershipGovernment - Hospital District or Authority
CMS Certification Number391308
Location965 Shamrock LaneCorry, PA 16407 · Erie County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 16501 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

93.78/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.07
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
100%148 patients5/55-star benchmark: 100%
Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older
Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months
100%92 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.

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
8 suppliers25 claims42 services$5.90 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
4 suppliers13 claims13 services$1.10 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
2 suppliers22 claims22 services$85.33 avg. paid by Medicare
Elevating leg rests, pair (for use with capped rental wheelchair base) K0195
DME-Wheelchairs · category DD021N
1 supplier16 claims16 services$8.43 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. BRIAN K LANG DO
Internal Medicine
240 W 11TH ST STE 301
ERIE, PA 16501
Erie County (814) 480-7770

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 Shawn Zeto's NPI number?

The NPI number for Shawn Zeto is 1306800040. It was assigned to this individual provider in the NPPES registry on April 12, 2006.

Where is Shawn Zeto located?

Shawn Zeto practices at 240 W 11th St Ste 301, Erie, PA 16501. The listed phone number is (814) 480-7770.

What is Shawn Zeto's specialty?

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

Is Shawn Zeto enrolled in Medicare?

Yes. Shawn Zeto 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 Shawn Zeto accept?

Health plans from Anthem Blue Cross and Blue Shield list Shawn Zeto 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 Shawn Zeto affiliated with any hospitals?

According to CMS data, Shawn Zeto is affiliated with Saint Vincent Hospital, Upmc Hamot and Lecom Health Corry Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Shawn Zeto was last updated on April 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.