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BANKIM D SHAH MD
NPI 1609899632
Internal Medicine in Toms River, NJ

Active since July 25, 2006PECOS EnrolledAccepts Medicare Assignment
25 MULE RD UNIT B4, TOMS RIVER, NJ 08755(732) 341-0020(732) 341-0072 Get Directions Write a Review

NPPES record last updated: April 8, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 8, 2019, Mar 18, 2019 (2 updates tracked since 2019).

About Bankim D Shah Md NPPES

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

BANKIM D SHAH MD (NPI 1609899632) is an individual internal medicine provider in Toms River, New Jersey, licensed in New Jersey (25MA03582500) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1976).

NPPES Registry Identity

NPI1609899632
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameBANKIM D SHAHCredential: MD
Location Address25 MULE RD UNIT B4Toms River, NJ 08755-5037
Mailing Address25 Mule Rd Unit B4Toms River, NJ 08755-5037 · (732) 341-0020 · Fax (732) 341-0072
Phone(732) 341-0020
Fax(732) 341-0072
Sole ProprietorNo
Medical School CMSOtherGraduated 1976
Enumeration DateJuly 25, 2006
Last NPPES UpdateApril 8, 20192 updates tracked since enumeration
✔ NPI 1609899632 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 · 25MA03582500
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.
25 MULE RD UNIT B4, Toms River, NJ 08755
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Other Identifiers 1

Other067431Medicare Provider #

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Bankim 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 ID8820014806
PECOS Enrollment IDI20120120000191
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.

Medicare Billing Reassignment

Medicare enrollment records show Bankim Shah reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Bankim D. Shah M.D. PA
Same address
Internal Medicine
25 MULE RD UNIT B4
Toms River, NJ 08755
  • Reassigned Medicare billing, New Jersey enrollment
  • 6 clinicians in this Medicare group
NPI 1992720809 (732) 341-0020

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 11

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 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.
152 services66 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.
126 services101 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
54 services52 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
31 services31 patients
Insertion of needle into vein (3 years or older) 36410
This procedure involves placing a small needle into a vein, typically in the arm. It's done to collect blood for testing or to deliver medication. You may feel a quick pinch, but it's usually over in seconds. It's a common, safe procedure.
26 services24 patients
Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes G0446
This is a yearly, personal consultation focused on behaviors affecting heart health. It lasts 15 minutes and may cover topics like diet, exercise, and stress management. It's about learning healthy habits to protect your heart.
26 services26 patients

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.

Reported Quality Measures

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.
75%834 patients3/55-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.
6%396 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.
97%259 patients4/55-star benchmark: 99%
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…
54%259 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
1%259 patients1/55-star benchmark: 59%
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 2

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
11 suppliers25 claims65 services$5.34 avg. paid by Medicare
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress E0303
DME-Hospital Beds · category DB000N
1 supplier11 claims11 services$100.81 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 4

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

DR. SWETA SHAH
Family Medicine
25 MULE RD UNIT B4
TOMS RIVER, NJ 08755
Ocean County (732) 341-0020
DHANVANTI B SHAH MD
Family Medicine
25 MULE RD UNIT B4
TOMS RIVER, NJ 08755
Ocean County (732) 341-0020
MRS. AMY VALANZOLA RDN
Dietitian, Registered
25 MULE RD UNIT B4
TOMS RIVER, NJ 08755
Ocean County (732) 341-0020
BANKIM D. SHAH M.D. PA
Internal Medicine
25 MULE RD UNIT B4
TOMS RIVER, NJ 08755
Ocean County (732) 341-0020

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 Bankim Shah's NPI number?

The NPI number for Bankim Shah is 1609899632. It was assigned to this individual provider in the NPPES registry on July 25, 2006.

Where is Bankim Shah located?

Bankim Shah practices at 25 Mule Rd Unit B4, Toms River, NJ 08755. The listed phone number is (732) 341-0020.

What is Bankim Shah's specialty?

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

Is Bankim Shah enrolled in Medicare?

Yes. Bankim 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.

Which organization bills Medicare for Bankim Shah's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Bankim Shah reassigns Medicare benefits to Bankim D. Shah M.D. PA (Toms River, NJ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Bankim Shah's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Bankim Shah accept?

Health plans from Oscar Health list Bankim 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.

When was this NPI record last updated?

The NPPES record for Bankim Shah was last updated on April 8, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.