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KETAN D. SHAH MD
NPI 1528098134
Internal Medicine in Charlotte, NC

Active since July 03, 2006PECOS EnrolledAccepts Medicare Assignment
95.35/100
CMS Quality Rating
14214 BALLANTYNE LAKE RD, STE 100, CHARLOTTE, NC 28277(704) 667-2650 Get Directions Write a Review

NPPES record last updated: July 15, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 15, 2024, May 4, 2023, Mar 9, 2023 and 53 more (56 updates tracked since 2017).

About Ketan D. Shah Md NPPES

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

KETAN D. SHAH MD (NPI 1528098134) is an individual internal medicine provider in Charlotte, North Carolina, licensed in North Carolina (200000133) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Carolinas Medical Center/behav Health, and is a graduate of Duke University School Of Medicine (1995).

NPPES Registry Identity

NPI1528098134
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameKETAN D. SHAHCredential: MD
Location Address14214 BALLANTYNE LAKE RD, STE 100Charlotte, NC 28277-3372
Mailing AddressPo Box 19305Charlotte, NC 28219-9305
Phone(704) 667-2650
Sole ProprietorNo
Medical School CMSDuke University School Of MedicineGraduated 1995
Enumeration DateJuly 3, 2006
Last NPPES UpdateJuly 15, 202456 updates tracked since enumeration
✔ NPI 1528098134 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NC · 200000133
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.
14214 BALLANTYNE LAKE RD, Charlotte, NC 28277
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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

Ketan D. 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 ID8628075405
PECOS Enrollment IDI20061109000223
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 5

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.
106 services104 patients
Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen 87635
This is a lab test that detects the presence of COVID-19 in your body. It uses a technique to amplify the virus's genetic material, either DNA or RNA, making it easier to identify. A positive result indicates an active infection.
27 services27 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.
23 services23 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
18 services18 patients
Detection test by nucleic acid for multiple types influenza virus 87502
A detection test by nucleic acid for multiple types of influenza virus is a diagnostic procedure. It identifies the genetic material of the virus in your body. It's highly accurate and can distinguish between different flu strains, helping in prompt and precise treatment.
18 services18 patients

Hospital Affiliations CMS Care Compare

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

Carolinas Medical Center/Behav Health

Acute Care Hospitals · Charlotte, NC
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340113
Location1000 Blythe BlvdCharlotte, NC 28203 · Mecklenburg County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28277 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.

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.

95.35/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality84.22
Promoting Interoperability100
Improvement Activities40

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.

PARDEEP KESRANI MD
Pediatrics
14214 BALLANTYNE LAKE RD, STE 300
CHARLOTTE, NC 28277
Mecklenburg County (704) 667-2600
MATTHEW RAYMOND SNOW PA
Physician Assistant
14214 BALLANTYNE LAKE RD, STE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 667-2650
BARNETT FAMILY PRACTICE
Family Medicine
14214 BALLANTYNE LAKE RD
CHARLOTTE, NC 28277
Mecklenburg County (803) 283-2011
ERIC DANIEL SENSENBRENNER DO
Internal Medicine
14214 BALLANTYNE LAKE RD, STE 150
CHARLOTTE, NC 28277
Mecklenburg County (704) 863-4878
PAUL SMOLEN
Pediatrics
14214 BALLANTYNE LAKE RD, SUITE 300
CHARLOTTE, NC 28277
Mecklenburg County (704) 667-2600
CAROLINAS MEDICAL CENTER
Pediatrics
14214 BALLANTYNE LAKE RD, SUITE 150
CHARLOTTE, NC 28277
Mecklenburg County (704) 667-2680
KIMBERLY SPAIN FNP
Nurse Practitioner
14214 BALLANTYNE LAKE RD, STE 100
CHARLOTTE, NC 28277
Mecklenburg County (704) 667-2650
CORINNE SIROIS RD
Dietitian, Registered
14214 BALLANTYNE LAKE RD, STE 200
CHARLOTTE, NC 28277
Mecklenburg County (704) 667-2681

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 Ketan Shah's NPI number?

The NPI number for Ketan Shah is 1528098134. It was assigned to this individual provider in the NPPES registry on July 3, 2006.

Where is Ketan Shah located?

Ketan Shah practices at 14214 Ballantyne Lake Rd Ste 100, Charlotte, NC 28277. The listed phone number is (704) 667-2650.

What is Ketan Shah's specialty?

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

Is Ketan Shah enrolled in Medicare?

Yes. Ketan 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 Ketan Shah accept?

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

According to CMS data, Ketan Shah is affiliated with Carolinas Medical Center/Behav Health.

When was this NPI record last updated?

The NPPES record for Ketan Shah was last updated on July 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.