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NILESH S. SHAH M.D.
NPI 1366590820
Otolaryngology in Seattle, WA

Active since January 08, 2007PECOS EnrolledAccepts Medicare Assignment
93.09/100
CMS Quality Rating
1536 N 115TH ST STE 340, SEATTLE, WA 98133(206) 520-5000 Get Directions Write a Review

NPPES record last updated: November 1, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Nilesh S. Shah M.d. NPPES

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

NILESH S. SHAH M.D. (NPI 1366590820) is an individual otolaryngology provider in Seattle, Washington, licensed in Washington (MD60086328) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, is affiliated with University Of Washington Medical Ctr, and is a graduate of Ohio State University College Of Medicine (2004).

NPPES Registry Identity

NPI1366590820
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameNILESH S. SHAHCredential: M.D.
Location Address1536 N 115TH ST STE 340Seattle, WA 98133-8412
Mailing AddressPo Box 50095Seattle, WA 98145-5095 · (206) 520-5700
Phone(206) 520-5000
Sole ProprietorNo
Medical School CMSOhio State University College Of MedicineGraduated 2004
Enumeration DateJanuary 8, 2007
Last NPPES UpdateNovember 1, 2019
✔ NPI 1366590820 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
Licenses✔ Licensed in WA · MD60086328✔ Licensed in NY · 239514
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
1536 N 115TH ST STE 340, Seattle, WA 98133
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Other Identifiers 1

Medicaid1366590820WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.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

Nilesh S. Shah M.d. 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 ID3678619855
PECOS Enrollment IDI20090930000755
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 11

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 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.
348 services225 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.
97 services70 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
87 services87 patients
Diagnostic exam of nasal passages using an endoscope 31231
A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.
73 services50 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.
52 services49 patients
Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
42 services40 patients

Hospital Affiliations CMS Care Compare

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

University Of Washington Medical Ctr

Acute Care Hospitals · Seattle, WA
3/5 CMS rating
OwnershipGovernment - State
CMS Certification Number500008
Location1959 NE Pacific St Box 356151Seattle, WA 98195 · King County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98133 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
$143.76 typical visit price
range $63.67 – $189.37
Typical copayment $35.94 (range $15.91 – $47.34)
Most-billed visit code 99204
Established Patient
$78.74 typical visit price
range $21.12 – $155.00
Typical copayment $19.68 (range $5.28 – $38.75)
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.

93.09/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality73.95
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 6

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
7 suppliers23 claims23 services$33.22 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
5 suppliers14 claims71 services$16.46 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
7 suppliers23 claims23 services$45.98 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
7 suppliers14 claims14 services$15.92 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
6 suppliers19 claims114 services$1.80 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
2 suppliers37 claims37 services$28.15 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Shah's NPI number?

The NPI number for Nilesh Shah is 1366590820. It was assigned to this individual provider in the NPPES registry on January 8, 2007.

Where is Nilesh Shah located?

Nilesh Shah practices at 1536 N 115th St Ste 340, Seattle, WA 98133. The listed phone number is (206) 520-5000.

What is Nilesh Shah's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Nilesh Shah enrolled in Medicare?

Yes. Nilesh 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 Nilesh Shah accept?

Health plans from PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Nilesh 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 Nilesh Shah affiliated with any hospitals?

According to CMS data, Nilesh Shah is affiliated with University Of Washington Medical Ctr.

When was this NPI record last updated?

The NPPES record for Nilesh Shah was last updated on November 1, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.