SONAL SHAH M.D.
NPI 1598170458
Hospitalist in Carbondale, IL

Active since June 30, 2014PECOS EnrolledAccepts Medicare Assignment
75.73/100
CMS Quality Rating
405 W JACKSON ST, CARBONDALE, IL 62901(618) 549-0721(618) 529-0479 Get Directions Write a Review

NPPES record last updated: January 6, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 6, 2021, Jul 22, 2020, Mar 8, 2019 (3 updates tracked since 2019).

About Sonal Shah M.d. NPPES

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

SONAL SHAH M.D. (NPI 1598170458) is an individual hospitalist provider in Carbondale, Illinois, licensed in Illinois (036141364) and active in the NPI registry since June 2014. She is enrolled in Medicare PECOS, is affiliated with Herrin Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1598170458
Entity TypeIndividualFemale
Primary Taxonomy208M00000X
Provider Legal NameSONAL SHAHCredential: M.D.
Location Address405 W JACKSON STCarbondale, IL 62901-1462
Mailing AddressPo Box 3988Carbondale, IL 62902-3988 · (618) 457-5200
Fax(618) 529-0479
Sole ProprietorNo
Medical School CMSSouthern Illinois University School Of MedicineGraduated 2017
Enumeration DateJune 30, 2014
Last NPPES UpdateJanuary 6, 20213 updates tracked since enumeration
NPPES CertifiedJanuary 6, 2021
NPI 1598170458 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License Licensed in IL · 036141364
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 036141364 (IL)
405 W JACKSON ST, Carbondale, IL 62901

Secondary Practice Locations 2

Location 1201 S 14th StHerrin, IL 62948-3631 · Phone (618) 942-2171 ext. 35760 · Fax (618) 988-6166
Location 22 S Hospital DrMurphysboro, IL 62966-3333 · Phone (618) 684-3156 ext. 55321 · Fax (618) 684-1040

Other Identifiers 1

Other214881IL · Multispecialty Group Ptan

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

Sonal Shah 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 ID2062637838
PECOS Enrollment IDI20161206002574
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 7

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 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.
308 services158 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
181 services171 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.
152 services142 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.
134 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.
34 services14 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
24 services24 patients

Hospital Affiliations CMS Care Compare 5

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

Herrin Hospital

Acute Care Hospitals · Herrin, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140011
Location201 S 14th StHerrin, IL 62948 · Williamson County
Emergency services

Heartland Regional Medical Center

Acute Care Hospitals · Marion, IL
2/5 CMS rating
OwnershipProprietary
CMS Certification Number140184
Location3333 W DeyoungMarion, IL 62959 · Williamson County
Emergency services

Crossroads Community Hospital

Acute Care Hospitals · Mount Vernon, IL
OwnershipProprietary
CMS Certification Number140294
Location8 Doctors Park RdMount Vernon, IL 62864 · Jefferson County
Emergency services

Anna Hospital Corporation D/B/A Union County Hospital

Critical Access Hospitals · Anna, IL
OwnershipProprietary
CMS Certification Number141342
Location517 North Main StreetAnna, IL 62906 · Union County
Emergency services

Deaconess Hospital Inc

Acute Care Hospitals · Evansville, IN
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150082
Location600 Mary StEvansville, IN 47710 · Vanderburgh County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62901 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
$127.46 typical visit price
range $54.80 – $168.44
Typical copayment $31.86 (range $13.70 – $42.11)
Most-billed visit code 99204
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

75.73/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality63.09
Promoting Interoperability100
Improvement Activities40
Cost45.26

Referred Medical Equipment & Supplies CMS DME claims 5

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers32 claims32 services$18.23 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
1 supplier12 claims12 services$922.57 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
6 suppliers62 claims62 services$93.25 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
1 supplier11 claims11 services$16.92 avg. paid by Medicare
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738
DME-Oxygen and Supplies · category DC000N
2 suppliers22 claims22 services$31.69 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 20

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

Physician Assistant
405 W JACKSON ST
CARBONDALE, IL 62901
Pathology (Anatomic Pathology & Clinical Pathology)
405 W JACKSON ST
CARBONDALE, IL 62901
Emergency Medicine
405 W JACKSON ST, MEMORIAL HOSPITAL
CARBONDALE, IL 62901
Anesthesiology
405 W JACKSON ST
CARBONDALE, IL 62901
Physician Assistant
405 W JACKSON ST
CARBONDALE, IL 62901
Nurse Anesthetist, Certified Registered
405 W JACKSON ST
CARBONDALE, IL 62901
Emergency Medicine
405 W JACKSON ST
CARBONDALE, IL 62901
Physician Assistant
405 W JACKSON ST
CARBONDALE, IL 62901

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 Sonal Shah's NPI number?

The NPI number for Sonal Shah is 1598170458. It was assigned to this individual provider in the NPPES registry on June 30, 2014.

Where is Sonal Shah located?

Sonal Shah practices at 405 W Jackson St, Carbondale, IL 62901. The listed phone number is (618) 549-0721.

What is Sonal Shah's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Sonal Shah enrolled in Medicare?

Yes. Sonal 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 Sonal Shah affiliated with any hospitals?

According to CMS data, Sonal Shah is affiliated with Herrin Hospital, Heartland Regional Medical Center, Crossroads Community Hospital, Anna Hospital Corporation D/B/A Union County Hospital and Deaconess Hospital Inc.

When was this NPI record last updated?

The NPPES record for Sonal Shah was last updated on January 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.