PRADIP A SHAH MD
NPI 1437175155
Internal Medicine - Infectious Disease in Edison, NJ

Q: What is Pradip Shah's NPI number?

The NPI number for Pradip Shah is 1437175155. It was assigned to this individual provider in the NPPES registry on July 14, 2006.

Q: What is Pradip Shah's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Q: When was this NPI record last updated?

The NPPES record for Pradip Shah was last updated on June 23, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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 July 14, 2006PECOS EnrolledAccepts Medicare Assignment

94.95/100

CMS Quality Rating

1964 OAK TREE RD, EDISON, NJ 08820(732) 635-0050(732) 635-0051 Get Directions Write a Review

NPPES record last updated: June 23, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Pradip A Shah Md NPPES

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

PRADIP A SHAH MD (NPI 1437175155) is an individual infectious disease provider in Edison, New Jersey, licensed in New Jersey (MA57551) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Morristown Medical Center, and is a graduate of Other (1973).

NPPES Registry Identity

NPI1437175155

Entity TypeIndividualMale

Primary Taxonomy207RI0200X

Provider Legal NamePRADIP A SHAHCredential: MD

Location Address1964 OAK TREE RDEdison, NJ 08820-2016

Mailing Address1964 Oak Tree RdEdison, NJ 08820-2016 · (732) 635-0050 · Fax (732) 635-0051

Phone(732) 635-0050

Fax(732) 635-0051

Sole ProprietorNo

Medical School CMSOtherGraduated 1973

Enumeration DateJuly 14, 2006

Last NPPES UpdateJune 23, 2015

✔ NPI 1437175155 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RI0200X

License✔ Licensed in NJ · MA57551

Definition

An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.

1964 OAK TREE RD, Edison, NJ 08820

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Other Identifiers 3

Medicare UPINF66240NJ

Medicare PIN151340NJ

Medicaid6068405NJ

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

Pradip A 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 ID345382537

PECOS Enrollment IDI20100127000107

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 14

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.

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.

2,309 services320 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

1,392 services296 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

328 services284 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.

295 services85 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.

255 services83 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

139 services30 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

108 services28 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.

101 services91 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

94 services80 patients

Management using the results of remote vital sign monitoring per calendar month, first 20 minutes 99457

This service involves reviewing and managing your health data, which is remotely monitored and collected. Your vital signs like heart rate and blood pressure are tracked regularly throughout the month. The first 20 minutes of this data analysis per month is included in this service.

57 services11 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

39 services37 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

22 services22 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.

17 services13 patients

Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment 99453

Remote monitoring of physiologic parameters involves using special equipment to track vital signs like heart rate and blood pressure from a distance. The initial set-up includes installing the device and teaching the patient how to use it correctly for accurate readings.

11 services11 patients

Hospital Affiliations CMS Care Compare 4

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

Morristown Medical Center

Acute Care Hospitals · Morristown, NJ

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310015

Location100 Madison AveMorristown, NJ 07960 · Morris County

Emergency services Birthing friendly

Robert Wood Johnson University Hospital At Rahway

Acute Care Hospitals · Rahway, NJ

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310024

Location865 Stone StRahway, NJ 07065 · Union County

Emergency services

Raritan Bay Medical Center

Acute Care Hospitals · Perth Amboy, NJ

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310039

Location530 New Brunswick AvePerth Amboy, NJ 08861 · Middlesex County

Emergency services Birthing friendly

Jfk Medical Center

Acute Care Hospitals · Edison, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310108

Location65 James StreetEdison, NJ 08820 · Middlesex County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08820 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.

94.95/100

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

Scored through an Alternative Payment Model

Quality

87.26

Promoting Interoperability

100

Improvement Activities

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.

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

2 suppliers29 claims29 services$38.71 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

4 suppliers28 claims28 services$57.61 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

3 suppliers18 claims18 services$30.59 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

1 supplier27 claims27 services$9.69 avg. paid by Medicare

Lightweight wheelchair K0003

DME-Wheelchairs · category DD000N

3 suppliers24 claims24 services$11.93 avg. paid by Medicare

Elevating leg rests, pair (for use with capped rental wheelchair base) K0195

DME-Wheelchairs · category DD021N

2 suppliers35 claims35 services$5.35 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 2

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

PRADIP A. SHAH, M.D. P.C.

Internal Medicine (Infectious Disease)

1964 OAK TREE RD
EDISON, NJ 08820

Middlesex County (732) 635-0050

POOJA SHAH MD

Internal Medicine (Infectious Disease)

1964 OAK TREE RD
EDISON, NJ 08820

Middlesex County (732) 635-0050

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 Pradip Shah's NPI number?

The NPI number for Pradip Shah is 1437175155. It was assigned to this individual provider in the NPPES registry on July 14, 2006.

Where is Pradip Shah located?

Pradip Shah practices at 1964 Oak Tree Rd, Edison, NJ 08820. The listed phone number is (732) 635-0050.

What is Pradip Shah's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Pradip Shah enrolled in Medicare?

Yes. Pradip 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 Pradip Shah accept?

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

According to CMS data, Pradip Shah is affiliated with Morristown Medical Center, Robert Wood Johnson University Hospital At Rahway, Raritan Bay Medical Center and Jfk Medical Center.

When was this NPI record last updated?

The NPPES record for Pradip Shah was last updated on June 23, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.