ANKUR SHETH M.D.
NPI 1396956140
Internal Medicine - Gastroenterology in Gainesville, GA
Active since May 24, 2007PECOS EnrolledAccepts Medicare Assignment
82.55/100
CMS Quality Rating
2324 LIMESTONE OVERLOOK, GAINESVILLE, GA 30501(770) 536-8109(770) 536-3203 Get Directions Write a Review
About Ankur Sheth M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANKUR SHETH M.D. (NPI 1396956140) is an individual gastroenterology provider in Gainesville, Georgia, licensed in Georgia (073061) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Northeast Georgia Medical Center, Inc, and maintains a secondary practice location in Gainesville.
NPPES Registry Identity
NPI1396956140
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameANKUR SHETHCredential: M.D.
Location Address2324 LIMESTONE OVERLOOKGainesville, GA 30501-7443
Mailing AddressPo Box 907790Gainesville, GA 30501-0912 · (678) 997-2140
Phone(770) 536-8109
Fax(770) 536-3203
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateMay 24, 2007
Last NPPES UpdateOctober 7, 20203 updates tracked since enumeration
NPPES CertifiedOctober 7, 2020
✔ NPI 1396956140 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 2
★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in GA · 073061
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
Also ListedPathology · Anatomic Pathology & Clinical PathologyTaxonomy 207ZP0102X · License 073061 (GA)
2324 LIMESTONE OVERLOOK, Gainesville, GA 30501
Secondary Practice Location 1
Location 1743 Spring St NEGainesville, GA 30501-3715 · Phone (770) 219-9000
Other Identifiers 2
Other4M936F600LA · Medicare - Ptan
Medicaid1071676LA
Accepted Insurance
The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..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
Ankur Sheth 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 ID5496885550
PECOS Enrollment IDI20150713000929
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 12
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.
Pathology examination of tissue using a microscope, intermediate complexity 88305
A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.
401 services174 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.
158 services126 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
144 services144 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.
114 services100 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
107 services107 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
58 services58 patients
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Northeast Georgia Medical Center, Inc
Acute Care Hospitals · Gainesville, GAOwnershipGovernment - Local
CMS Certification Number110029
Location743 Spring StreetGainesville, GA 30501 · Hall County
Emergency services Birthing friendly
Ngmc Barrow, LLC
Acute Care Hospitals · Winder, GAOwnershipProprietary
CMS Certification Number110045
Location316 North Broad StreetWinder, GA 30680 · Barrow County
Emergency services
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30501 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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.
82.55/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practiceQuality
81.14
Promoting Interoperability
100
Improvement Activities
40
Cost
60.7
Reported Quality Measures
Closing the Referral Loop: Receipt of Specialist Report
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
77%141 patients4/55-star benchmark: 95%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
83%707 patients4/55-star benchmark: 85%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
76%46 patients4/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%1,542 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
93%1,521 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
28%192 patients2/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
91%1,107 patients3/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
77%1,774 patients4/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
99%536 patients5/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
26%1,296 patients2/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
82%539 patients4/55-star benchmark: 88%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 95% · 357 patients
Patients tobacco: 84% · 357 patients
5%40 patients1/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
98%1,774 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
10%1,774 patients1/55-star benchmark: 89%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period: - Adults aged >= 21 years who were previously diagnosed with or currently have an active…
91%34 patients5/55-star benchmark: 89%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 536 patients
1%536 patients4/55-star benchmark: 100%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
21%1,774 patients
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.
Nurse Practitioner (Acute Care)
2324 LIMESTONE OVERLOOK
GAINESVILLE, GA 30501
GAINESVILLE, GA 30501
Nurse Practitioner (Family)
2324 LIMESTONE OVERLOOK
GAINESVILLE, GA 30501
GAINESVILLE, GA 30501
Internal Medicine (Gastroenterology)
2324 LIMESTONE OVERLOOK
GAINESVILLE, GA 30501
GAINESVILLE, GA 30501
Internal Medicine (Gastroenterology)
2324 LIMESTONE OVERLOOK
GAINESVILLE, GA 30501
GAINESVILLE, GA 30501
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 Ankur Sheth's NPI number?
The NPI number for Ankur Sheth is 1396956140. It was assigned to this individual provider in the NPPES registry on May 24, 2007.
Where is Ankur Sheth located?
Ankur Sheth practices at 2324 Limestone Overlook, Gainesville, GA 30501. The listed phone number is (770) 536-8109.
What is Ankur Sheth's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.
Is Ankur Sheth enrolled in Medicare?
Yes. Ankur 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 Ankur Sheth accept?
Health plans from Alliant Health Plans, Inc. list Ankur 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.
Is Ankur Sheth affiliated with any hospitals?
According to CMS data, Ankur Sheth is affiliated with Northeast Georgia Medical Center, Inc and Ngmc Barrow, LLC.
When was this NPI record last updated?
The NPPES record for Ankur Sheth was last updated on October 7, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.
