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DR. RIDDHISHKUMAR SHAH MD PHD
NPI 1417184235
Internal Medicine in Raleigh, NC

Active since June 18, 2009PECOS EnrolledAccepts Medicare Assignment
3404 WAKE FOREST RD, RALEIGH, NC 27609(919) 862-5400 Get Directions Write a Review

NPPES record last updated: July 1, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Riddhishkumar Shah Md Phd NPPES

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

DR. RIDDHISHKUMAR SHAH MD PHD (NPI 1417184235) is an individual internal medicine provider in Raleigh, North Carolina, licensed in North Carolina (157263) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS, is affiliated with Duke University Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1417184235
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. RIDDHISHKUMAR SHAHCredential: MD PHD
Location Address3404 WAKE FOREST RDRaleigh, NC 27609
Mailing Address3404 Wake Forest RdRaleigh, NC 27609-7340 · (919) 862-5400
Phone(919) 862-5400
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateJune 18, 2009
Last NPPES UpdateJuly 1, 2019
✔ NPI 1417184235 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NC · 157263
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 ListedInternal Medicine · Hematology & OncologyTaxonomy 207RH0003X · License 157263 (NC)
3404 WAKE FOREST RD, Raleigh, NC 27609
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11900 Kildaire Farm Rd, hospitalist officeCary, NC 27518-6616 · Phone (919) 350-1965
Location 2216 Ashville Ave Ste 20Cary, NC 27518-6679 · Phone (919) 781-7070

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee 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. Riddhishkumar Shah Md Phd 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 ID3274789318
PECOS Enrollment IDI20120806000815
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.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
189 services54 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
60 services19 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
23 services23 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
17 services17 patients

Hospital Affiliations CMS Care Compare

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

Duke University Hospital

Acute Care Hospitals · Durham, NC
5/5 CMS rating
OwnershipProprietary
CMS Certification Number340030
Location2100 Erwin RdDurham, NC 27705 · Durham County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27609 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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.

Referred Medical Equipment & Supplies CMS DME claims 3

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

Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) A4221
DME-Other DME · category DE017N
1 supplier48 claims48 services$18.52 avg. paid by Medicare
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) A4222
DME-Medical/Surgical Supplies · category DA000N
1 supplier49 claims50 services$35.94 avg. paid by Medicare
Injection, fluorouracil, 500 mg J9190
Treatment-Chemotherapy · category RH002N
1 supplier49 claims491 services$1.61 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 20

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

CASEY JOHNSON MS OTRL
Occupational Therapist (Hand)
3404 WAKE FOREST RD, SUITE 303
RALEIGH, NC 27609
Wake County (919) 872-3171
WINDSOR AUSTIN HOLT MD
Obstetrics & Gynecology
3404 WAKE FOREST RD, SUITE 100
RALEIGH, NC 27609
Wake County (919) 876-8225
MELISSA JO PETERSON NP-BC
Nurse Practitioner (Family)
3404 WAKE FOREST RD
RALEIGH, NC 27609
Wake County (919) 862-5400
MRS. MEGAN KATHLEEN BLACK MSN, APRN, AGNP-C
Nurse Practitioner
3404 WAKE FOREST RD
RALEIGH, NC 27609
Wake County (919) 862-5402
SOUTHEASTERN ORTHOPEDICS SPORTS MEDICINE & SHOULDER CENTER PA
Clinic/Center (Multi-Specialty)
3404 WAKE FOREST RD, STE 201
RALEIGH, NC 27609
Wake County (919) 256-1511
DR. MICHAEL DAVID SPIRITOS M.D.
Internal Medicine (Hematology & Oncology)
3404 WAKE FOREST RD, SUITE 202
RALEIGH, NC 27609
Wake County (919) 954-3050
PRIVATE DIAGNOSTIC CLINIC, PLLC
Internal Medicine (Hematology & Oncology)
3404 WAKE FOREST RD, SUITE 100
RALEIGH, NC 27609
Wake County (919) 954-3050
PRIVATE DIAGNOSTIC CLINIC, PLLC
Surgery (Surgical Oncology)
3404 WAKE FOREST RD, SUITE 101
RALEIGH, NC 27609
Wake County (919) 954-3050

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 Riddhishkumar Shah's NPI number?

The NPI number for Riddhishkumar Shah is 1417184235. It was assigned to this individual provider in the NPPES registry on June 18, 2009.

Where is Riddhishkumar Shah located?

Riddhishkumar Shah practices at 3404 Wake Forest Rd, Raleigh, NC 27609. The listed phone number is (919) 862-5400.

What is Riddhishkumar Shah's specialty?

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

Is Riddhishkumar Shah enrolled in Medicare?

Yes. Riddhishkumar 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 Riddhishkumar Shah accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and Blue Cross and Blue Shield of NC list Riddhishkumar 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 Riddhishkumar Shah affiliated with any hospitals?

According to CMS data, Riddhishkumar Shah is affiliated with Duke University Hospital.

When was this NPI record last updated?

The NPPES record for Riddhishkumar Shah was last updated on July 1, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.