DR. SHYAM VEKARIA M.D.
NPI 1457581639
Orthopaedic Surgery in Lawrenceville, GA

Active since July 21, 2009PECOS EnrolledAccepts Medicare Assignment
90.8/100
CMS Quality Rating
771 OLD NORCROSS RD STE 390, LAWRENCEVILLE, GA 30046(678) 957-0757(678) 957-9597 Get Directions Write a Review

NPPES record last updated: November 16, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 16, 2022, Aug 25, 2021, Jun 28, 2017 and 1 more (4 updates tracked since 2016).

About Dr. Shyam Vekaria M.d. NPPES

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

DR. SHYAM VEKARIA M.D. (NPI 1457581639) is an individual orthopaedic surgery provider in Lawrenceville, Georgia, licensed in Georgia (89252) and active in the NPI registry since July 2009. He is enrolled in Medicare PECOS, is affiliated with Northside Hospital Forsyth, and maintains a secondary practice location in Johns Creek.

NPPES Registry Identity

NPI1457581639
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. SHYAM VEKARIACredential: M.D.
Location Address771 OLD NORCROSS RD STE 390Lawrenceville, GA 30046-4324
Mailing Address900 Circle 75 Pkwy Se Ste 1700Atlanta, GA 30339-3087 · (770) 953-6929 · Fax (770) 953-6972
Fax(678) 957-9597
Sole ProprietorYes
Medical School CMSNorthwestern University Feinberg Medical SchoolGraduated 2009
Enumeration DateJuly 21, 2009
Last NPPES UpdateNovember 16, 20224 updates tracked since enumeration
NPPES CertifiedNovember 16, 2022
NPI 1457581639 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License Licensed in GA · 89252
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
771 OLD NORCROSS RD STE 390, Lawrenceville, GA 30046

Secondary Practice Location 1

Location 16300 Hospital Pkwy Ste 400Johns Creek, GA 30097-1983 · Phone (678) 205-4261 · Fax (678) 417-7187

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted 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. Shyam Vekaria 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 ID7315164308
PECOS Enrollment IDI20210713001369
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 18

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 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.
161 services132 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.
159 services123 patients
X-ray of knee, 4 or more views 73564
An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.
88 services85 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
87 services60 patients
X-ray of hip, 2-3 views 73502
An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.
64 services58 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.
53 services53 patients

Hospital Affiliations CMS Care Compare 4

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

Northside Hospital Forsyth

Acute Care Hospitals · Cumming, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110005
Location1200 Northside Forsyth DriveCumming, GA 30041 · Forsyth County
Birthing friendly

Northside Hospital Gwinnett

Acute Care Hospitals · Lawrenceville, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110087
Location1000 Medical Center BoulevardLawrenceville, GA 30046 · Gwinnett County
Birthing friendly

Piedmont Eastside Medical Center

Acute Care Hospitals · Snellville, GA
2/5 CMS rating
OwnershipProprietary
CMS Certification Number110192
Location1700 Medical WaySnellville, GA 30078 · Gwinnett County
Emergency services Birthing friendly

Northside Hospital Duluth

Acute Care Hospitals · Duluth, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110252
Location3620 Howell Ferry RoadDuluth, GA 30096 · Gwinnett County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30046 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
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$70.85 typical visit price
range $18.22 – $140.40
Typical copayment $17.71 (range $4.55 – $35.10)
Most-billed visit code 99213
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.

90.8/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability98
Improvement Activities20

Reported Quality Measures

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.
41%6,521 patients1/55-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.
97%723 patients4/55-star benchmark: 100%
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.
10%1,201 patients1/55-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%1,201 patients3/55-star benchmark: 99%
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…
23%2,840 patients1/55-star benchmark: 97%
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: 86% · 1,510 patients
Patients tobacco: 7% · 1,510 patients
1%1,195 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…
100%1,201 patients5/55-star benchmark: 100%
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+: 1% · 1,038 patients
11%1,038 patients2/55-star benchmark: 100%
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.

Referred Medical Equipment & Supplies CMS DME claims

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

Walker, folding, wheeled, adjustable or fixed height E0143
DME-Other DME · category DE000N
3 suppliers21 claims21 services$43.74 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 6

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

Physician Assistant (Surgical)
771 OLD NORCROSS RD STE 390
LAWRENCEVILLE, GA 30046
Physician Assistant
771 OLD NORCROSS RD STE 390
LAWRENCEVILLE, GA 30046
Specialist
771 OLD NORCROSS RD STE 390
LAWRENCEVILLE, GA 30046
Specialist/Technologist (Athletic Trainer)
771 OLD NORCROSS RD STE 390
LAWRENCEVILLE, GA 30046
Physician Assistant
771 OLD NORCROSS RD STE 390
LAWRENCEVILLE, GA 30046
Physical Medicine & Rehabilitation
771 OLD NORCROSS RD STE 390
LAWRENCEVILLE, GA 30046

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 Shyam Vekaria's NPI number?

The NPI number for Shyam Vekaria is 1457581639. It was assigned to this individual provider in the NPPES registry on July 21, 2009.

Where is Shyam Vekaria located?

Shyam Vekaria practices at 771 Old Norcross Rd Ste 390, Lawrenceville, GA 30046. The listed phone number is (678) 957-0757.

What is Shyam Vekaria's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Shyam Vekaria enrolled in Medicare?

Yes. Shyam Vekaria 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 Shyam Vekaria accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Shyam Vekaria 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 Shyam Vekaria affiliated with any hospitals?

According to CMS data, Shyam Vekaria is affiliated with Northside Hospital Forsyth, Northside Hospital Gwinnett, Piedmont Eastside Medical Center and Northside Hospital Duluth.

When was this NPI record last updated?

The NPPES record for Shyam Vekaria was last updated on November 16, 2022. 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.