DR. NILAMBEN D SHAH MD
NPI 1356306070
Internal Medicine in Saint Petersburg, FL

Q: What is Nilamben Shah's NPI number?

The NPI number for Nilamben Shah is 1356306070. It was assigned to this individual provider in the NPPES registry on April 18, 2006. The provider is also known as Dr. Nilam D Shah MD.

Q: What is Nilamben Shah's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Nilamben Shah was last updated on January 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 April 18, 2006PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

5778 5TH AVE N, SAINT PETERSBURG, FL 33710(727) 388-2625(727) 828-9233 Get Directions Write a Review

NPPES record last updated: January 30, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 8, 2023, Jun 11, 2019, Jun 16, 2018 and 3 more (6 updates tracked since 2016).

On this page

About Dr. Nilamben D Shah Md NPPES

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

DR. NILAMBEN D SHAH MD (NPI 1356306070) is an individual internal medicine provider in Saint Petersburg, Florida, licensed in Florida (ME88506) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS, is affiliated with St Anthonys Hospital, and is a graduate of Other (1996).

NPPES Registry Identity

NPI1356306070

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameDR. NILAMBEN D SHAHCredential: MD

Location Address5778 5TH AVE NSaint Petersburg, FL 33710-7104

Mailing Address5778 5th Ave NSaint Petersburg, FL 33710-7104 · (727) 388-2625 · Fax (727) 828-9233

Phone(727) 388-2625

Fax(727) 828-9233

Sole ProprietorNo

Medical School CMSOtherGraduated 1996

Enumeration DateApril 18, 2006

Last NPPES UpdateJanuary 30, 20246 updates tracked since enumeration

NPPES CertifiedJanuary 30, 2024

✔ NPI 1356306070 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in FL · ME88506

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.

5778 5TH AVE N, Saint Petersburg, FL 33710

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Other Names 1

Other Name (5)Dr. Nilam D Shah Md

Other Identifiers 2

Medicaid020378900FL

Medicaid117015000FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) 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. Nilamben D 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 ID4183697055

PECOS Enrollment IDI20040818000622

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 28

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.

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

1,280 services202 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.

1,216 services321 patients

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

643 services117 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.

287 services287 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.

212 services134 patients

Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allow G0181

This service involves a physician overseeing your care while you receive Medicare-covered services from a home health agency. The care you're receiving is complex and involves various disciplines. The physician isn't physically present but regularly supervises your treatment to ensure optimal health outcomes.

159 services57 patients

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional 99211

This service involves an outpatient visit for established patients who may not need direct interaction with a healthcare professional. It could include reviewing test results, monitoring existing conditions, or adjusting treatment plans. It's typically done remotely, ensuring your comfort and convenience.

147 services95 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

130 services33 patients

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 G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

119 services84 patients

Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg J3420

This is a procedure where a small dose of Vitamin B-12, also known as Cyanocobalamin, is injected into your body. This vitamin is essential for nerve function and the production of red blood cells. It's often used to treat vitamin B-12 deficiency.

104 services21 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

94 services92 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

86 services83 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

76 services40 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.

75 services20 patients

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.

68 services50 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.

60 services60 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

53 services28 patients

Physician or allowed practitioner re-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 a G0179

This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.

50 services29 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

47 services22 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

36 services30 patients

Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes 99344

A new patient home visit is a comprehensive service where a healthcare professional visits your home for about an hour. This visit includes an overall health assessment, discussion about your medical history, and planning for future healthcare needs. The goal is to understand your health status and provide personalized care.

34 services34 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

28 services25 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

24 services23 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

20 services17 patients

Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) G0506

This service involves a thorough evaluation of patients needing ongoing care for chronic conditions. It includes creating a tailored care plan, coordinating with healthcare providers, and monitoring progress regularly. The goal is to provide optimal, personalized care for your long-term health needs.

17 services17 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

15 services14 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

13 services13 patients

Residence visit for new patient with low level of medical decision making, per day, if using time, at least 30 minutes 99342

A new patient home visit is a 30-minute appointment where a healthcare provider comes to your home to assess your health needs. This can include discussing your medical history, current conditions, and treatment plans. It's a convenient way to receive care in your own environment.

11 services11 patients

Hospital Affiliations CMS Care Compare 4

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

St Anthonys Hospital

Acute Care Hospitals · Saint Petersburg, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number100067

Location1200 Seventh Ave NSaint Petersburg, FL 33705 · Pinellas County

Emergency services

St Josephs Hospital

Acute Care Hospitals · Tampa, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number100075

Location3001 W Martin Luther King Jr BlvdTampa, FL 33677 · Hillsborough County

Emergency services Birthing friendly

Hca Florida Pasadena Hospital

Acute Care Hospitals · Saint Petersburg, FL

3/5 CMS rating

OwnershipProprietary

CMS Certification Number100126

Location1501 Pasadena Ave SSaint Petersburg, FL 33707 · Pinellas County

Emergency services

Hca Florida St Petersburg Hospital

Acute Care Hospitals · Saint Petersburg, FL

2/5 CMS rating

OwnershipProprietary

CMS Certification Number100180

Location6500 38th Ave NSaint Petersburg, FL 33710 · Pinellas County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33710 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

$130.04 typical visit price

range $56.00 – $171.84

Typical copayment $32.51 (range $14.00 – $42.96)

Most-billed visit code 99204

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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

Quality

89.88

Improvement Activities

Reported Quality Measures

Breast Cancer Screening

71%565 patients4/55-star benchmark: 93%

Colorectal Cancer Screening

61%984 patients3/55-star benchmark: 88%

Controlling High Blood Pressure

67%656 patients3/55-star benchmark: 91%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

29%216 patients4/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

99%9,304 patients4/55-star benchmark: 100%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

76%1,627 patients4/55-star benchmark: 97%

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 12

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 suppliers18 claims38 services$6.60 avg. paid by Medicare

Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) A4314

DME-Orthotic Devices · category DF000N

1 supplier12 claims12 services$19.00 avg. paid by Medicare

Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4035

Other-Enteral and Parenteral · category OB006N

2 suppliers25 claims530 services$5.16 avg. paid by Medicare

Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152

Other-Enteral and Parenteral · category OB006N

2 suppliers25 claims10,057 services$0.28 avg. paid by Medicare

Walker, with trunk support, adjustable or fixed height, any type E0140

DME-Other DME · category DE000N

1 supplier14 claims14 services$15.71 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

3 suppliers17 claims18 services$36.68 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 3

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

NILAM D SHAH PA

Clinic/Center (Primary Care)

5778 5TH AVE N
SAINT PETERSBURG, FL 33710

Pinellas County (727) 388-2625

USHA JOSHI

Nurse Practitioner (Family)

5778 5TH AVE N
ST PETERSBURG, FL 33710

Pinellas County (727) 388-2625

KRUPA PATEL

Physician Assistant

5778 5TH AVE N
ST PETERSBURG, FL 33710

Pinellas County (727) 388-2625

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 Nilamben Shah's NPI number?

The NPI number for Nilamben Shah is 1356306070. It was assigned to this individual provider in the NPPES registry on April 18, 2006. The provider is also known as Dr. Nilam D Shah MD.

Where is Nilamben Shah located?

Nilamben Shah practices at 5778 5th Ave N, Saint Petersburg, FL 33710. The listed phone number is (727) 388-2625.

What is Nilamben Shah's specialty?

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

Is Nilamben Shah enrolled in Medicare?

Yes. Nilamben 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 Nilamben Shah accept?

Health plans from AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Molina Healthcare and UnitedHealthcare list Nilamben 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 Nilamben Shah affiliated with any hospitals?

According to CMS data, Nilamben Shah is affiliated with St Anthonys Hospital, St Josephs Hospital, Hca Florida Pasadena Hospital and Hca Florida St Petersburg Hospital.

When was this NPI record last updated?

The NPPES record for Nilamben Shah was last updated on January 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.