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DR. MEHUL N SHAH MD
NPI 1427119247
Internal Medicine - Gastroenterology in Millburn, NJ

Active since December 13, 2006PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
116 MILLBURN AVE, SUITE 214, MILLBURN, NJ 07041(973) 378-2121(973) 467-0150 Get Directions Write a Review

NPPES record last updated: June 25, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Mehul N Shah Md NPPES

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

DR. MEHUL N SHAH MD (NPI 1427119247) is an individual gastroenterology provider in Millburn, New Jersey, licensed in New Jersey (25MA04839600) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS, is affiliated with Clara Maass Medical Center, and is a graduate of Other (1980).

NPPES Registry Identity

NPI1427119247
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDR. MEHUL N SHAHCredential: MD
Location Address116 MILLBURN AVE, SUITE 214Millburn, NJ 07041
Mailing Address128 Hartshorn DrShort Hills, NJ 07078-1613 · (973) 378-2121 · Fax (973) 467-0150
Phone(973) 378-2121
Fax(973) 467-0150
Sole ProprietorNo
Medical School CMSOtherGraduated 1980
Enumeration DateDecember 13, 2006
Last NPPES UpdateJune 25, 2014
✔ NPI 1427119247 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 NJ · 25MA04839600
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 ListedInternal MedicineTaxonomy 207R00000X · License 25MA04839600 (NJ)
116 MILLBURN AVE, Millburn, NJ 07041
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Other Identifiers 2

Medicare UPINE75159
Medicaid4590007NJ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.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. Mehul N 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 ID3274504592
PECOS Enrollment IDI20040802000945
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 10

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.
279 services188 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
244 services137 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.
82 services82 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.
75 services73 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.
67 services53 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.
61 services61 patients

Hospital Affiliations CMS Care Compare 2

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

Clara Maass Medical Center

Acute Care Hospitals · Belleville, NJ
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310009
LocationOne Clara Maass DriveBelleville, NJ 07109 · Essex County
Emergency services Birthing friendly

Saint Michael's Medical Center

Acute Care Hospitals · Newark, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310096
Location111 Central AvenueNewark, NJ 07102 · Essex County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07041 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
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
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
Scored as part of a group practice
Quality100
Improvement Activities40
Cost67.02

Reported Quality Measures

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.
74%388 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.
55%641 patients3/55-star benchmark: 99%
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…
25%641 patients2/55-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…
0%641 patients1/55-star benchmark: 59%
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 16

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

DENTAL CHARM LLC
Clinic/Center (Dental)
116 MILLBURN AVE, SUITE 109
MILLBURN, NJ 07041
Essex County (973) 921-9097
RAJENDRA DESAI MD
Internal Medicine (Cardiovascular Disease)
116 MILLBURN AVE, SUITE 213
MILLBURN, NJ 07041
Essex County (973) 376-8454
DR. YATINDER BAINS M.D.
Internal Medicine (Gastroenterology)
116 MILLBURN AVE, SUITE # 214
MILLBURN, NJ 07041
Essex County (973) 376-2121
PRATIBHA AVINASH KULKARNI M.D.
Internal Medicine
116 MILLBURN AVE, SUITE # 108
MILLBURN, NJ 07041
Essex County (973) 564-5227
DR. GEORGE KIHICZAK M.D.
Dermatology (Procedural Dermatology)
116 MILLBURN AVE, SUITE 111
MILLBURN, NJ 07041
Essex County (973) 467-5499
MRS. QAISRA YASMIN SAEED MD
Internal Medicine (Cardiovascular Disease)
116 MILLBURN AVE, SUITE 214
MILLBURN, NJ 07041
Essex County (973) 218-6000
RICKERS & KULKARNI MEDICAL GROUP PA
Internal Medicine
116 MILLBURN AVE, SUITE 108
MILLBURN, NJ 07041
Essex County (973) 564-5227
DR. TANDEEP K CHEEMA DDS
Dentist
116 MILLBURN AVE, SUITE 215
MILLBURN, NJ 07041
Essex County (516) 661-8071

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 Mehul Shah's NPI number?

The NPI number for Mehul Shah is 1427119247. It was assigned to this individual provider in the NPPES registry on December 13, 2006.

Where is Mehul Shah located?

Mehul Shah practices at 116 Millburn Ave Suite 214, Millburn, NJ 07041. The listed phone number is (973) 378-2121.

What is Mehul Shah's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Mehul Shah enrolled in Medicare?

Yes. Mehul 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 Mehul Shah accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Mehul 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 Mehul Shah affiliated with any hospitals?

According to CMS data, Mehul Shah is affiliated with Clara Maass Medical Center and Saint Michael's Medical Center.

When was this NPI record last updated?

The NPPES record for Mehul Shah was last updated on June 25, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.