SHAWN JAY SETHI DO
NPI 1417487067
Emergency Medicine in Durham, NC

Q: What is Shawn Sethi's NPI number?

The NPI number for Shawn Sethi is 1417487067. It was assigned to this individual provider in the NPPES registry on June 15, 2017.

Q: What is Shawn Sethi's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for Shawn Sethi was last updated on July 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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 June 15, 2017PECOS EnrolledAccepts Medicare Assignment

92.26/100

CMS Quality Rating

2301 ERWIN RD, DURHAM, NC 27710(919) 684-2413 Get Directions Write a Review

NPPES record last updated: July 11, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 11, 2023, Jun 24, 2021, Jun 19, 2021 and 2 more (5 updates tracked since 2017).

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About Shawn Jay Sethi Do NPPES

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

SHAWN JAY SETHI DO (NPI 1417487067) is an individual emergency medicine provider in Durham, North Carolina, licensed in North Carolina (2023-00488) and active in the NPI registry since June 2017. He is enrolled in Medicare PECOS, is affiliated with Duke University Hospital, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1417487067

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameSHAWN JAY SETHICredential: DO

Location Address2301 ERWIN RDDurham, NC 27710-3018

Mailing Address531 Asbury Cir Ste N340Atlanta, GA 30322-1006 · (404) 778-2624

Phone(919) 684-2413

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateJune 15, 2017

Last NPPES UpdateJuly 11, 20235 updates tracked since enumeration

NPPES CertifiedJuly 11, 2023

✔ NPI 1417487067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

Licenses✔ Licensed in NC · 2023-00488✔ Licensed in GA · 88042✔ Licensed in PA · OT018093

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License OT018093 (PA)

2301 ERWIN RD, Durham, NC 27710

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.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

Shawn Jay Sethi Do 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 ID4981003589

PECOS Enrollment IDI20230712002914

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 9

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.

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

197 services191 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

58 services58 patients

Ultrasound of heart, follow-up 93308

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

39 services39 patients

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

30 services30 patients

Ultrasound scan of chest 76604

An ultrasound scan of the chest is a non-invasive imaging procedure that uses sound waves to create pictures of the structures within your chest, such as your heart and lungs. It's a safe, painless method that helps doctors diagnose and monitor various conditions.

19 services19 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.

18 services18 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 27710 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

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

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.

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.

92.26/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

73.83

Promoting Interoperability

100

Improvement Activities

Leave this field empty

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.

CANDICE MARLOW RAY M.D.

Pediatrics (Pediatric Critical Care Medicine)