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DR. PRANAY SUDHIR SHAH D.O.
NPI 1528448115
Internal Medicine in Toms River, NJ

Active since June 09, 2015PECOS EnrolledAccepts Medicare Assignment
91.25/100
CMS Quality Rating
99 RTE 37 W, TOMS RIVER, NJ 08755(908) 217-7437 Get Directions Write a Review

NPPES record last updated: February 13, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Pranay Sudhir Shah D.o. NPPES

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

DR. PRANAY SUDHIR SHAH D.O. (NPI 1528448115) is an individual internal medicine provider in Toms River, New Jersey, licensed in New Jersey (25MB12482000) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS, is affiliated with Community Medical Center, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1528448115
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. PRANAY SUDHIR SHAHCredential: D.O.
Location Address99 RTE 37 WToms River, NJ 08755-6423
Mailing Address99 Rte 37 WToms River, NJ 08755-6423 · (718) 810-2062
Phone(908) 217-7437
Sole ProprietorYes
Medical School CMSOtherGraduated 2015
Enumeration DateJune 9, 2015
Last NPPES UpdateFebruary 13, 2026
NPPES CertifiedFebruary 13, 2026
✔ NPI 1528448115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NJ · 25MB12482000
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.
99 RTE 37 W, Toms River, NJ 08755
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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. Pranay Sudhir Shah D.o. 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 ID3476842683
PECOS Enrollment IDI20251224002451
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

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.

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.
307 services291 patients

Hospital Affiliations CMS Care Compare

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

Community Medical Center

Acute Care Hospitals · Toms River, NJ
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310041
Location99 Rt 37 WestToms River, NJ 08755 · Ocean County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08755 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
$140.34 typical visit price
range $61.59 – $185.05
Typical copayment $35.08 (range $15.39 – $46.26)
Most-billed visit code 99204
Established Patient
$107.94 typical visit price
range $20.08 – $150.98
Typical copayment $26.98 (range $5.02 – $37.74)
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.

91.25/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality74.92
Promoting Interoperability91.67
Improvement Activities40

Other Providers at the Same Location NPPES 19

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

MR. CHRISTOPHER WASHINGTON CRNA
Nurse Anesthetist, Certified Registered
99 RTE 37 W
TOMS RIVER, NJ 08755
Ocean County (609) 652-1000
DR. MERRITT WEAVER BROWN III M.D.
Psychiatry & Neurology (Neurology)
99 RTE 37 W
TOMS RIVER, NJ 08755
Ocean County (833) 656-3876
LAUREN CAMPISANO PA
Physician Assistant (Medical)
99 RTE 37 W
TOMS RIVER, NJ 08755
Ocean County (732) 557-8000
ABDALMAJEED IYOUN MD
Student in an Organized Health Care Education/Training Program
99 RTE 37 W
TOMS RIVER, NJ 08755
Ocean County (732) 557-2090
NICHOLAS JESUS FLORES DNP, CRNA
Nurse Anesthetist, Certified Registered
99 RTE 37 W
TOMS RIVER, NJ 08755
Ocean County (732) 557-8000
NIKUNJKUMAR PATEL
Internal Medicine (Endocrinology, Diabetes & Metabolism)
99 RTE 37 W
TOMS RIVER, NJ 08755
Ocean County (732) 781-6428
TOMS RIVER INPATIENT SERVICES LLC
Hospitalist
99 RTE 37 W
TOMS RIVER, NJ 08755
Ocean County (973) 251-1132
DR. WILLIAM KENNETH BONNAH BOATENG MD
Internal Medicine
99 RTE 37 W
TOMS RIVER, NJ 08755
Ocean County (732) 557-2061

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 Pranay Shah's NPI number?

The NPI number for Pranay Shah is 1528448115. It was assigned to this individual provider in the NPPES registry on June 9, 2015.

Where is Pranay Shah located?

Pranay Shah practices at 99 Rte 37 W, Toms River, NJ 08755. The listed phone number is (908) 217-7437.

What is Pranay Shah's specialty?

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

Is Pranay Shah enrolled in Medicare?

Yes. Pranay 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.

Is Pranay Shah affiliated with any hospitals?

According to CMS data, Pranay Shah is affiliated with Community Medical Center.

When was this NPI record last updated?

The NPPES record for Pranay Shah was last updated on February 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.