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DR. THOMAS SHEFTEL MD
NPI 1619060365
Internal Medicine - Infectious Disease in Marietta, GA

Active since October 02, 2006PECOS EnrolledAccepts Medicare Assignment
92.93/100
CMS Quality Rating
55 WHITCHER ST NE, SUITE 220, MARIETTA, GA 30060(770) 429-0083(770) 425-0137 Get Directions Write a Review

NPPES record last updated: September 30, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Thomas Sheftel Md NPPES

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

DR. THOMAS SHEFTEL MD (NPI 1619060365) is an individual infectious disease provider in Marietta, Georgia, licensed in Georgia (027663) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with Wellstar Kennestone Regional Medical Center, and is a graduate of Kansas City Medical College (1979).

NPPES Registry Identity

NPI1619060365
Entity TypeIndividualMale
Primary Taxonomy207RI0200X
Provider Legal NameDR. THOMAS SHEFTELCredential: MD
Location Address55 WHITCHER ST NE, SUITE 220Marietta, GA 30060-1155
Mailing Address55 Whitcher St Ne, Suite 220Marietta, GA 30060-1155 · (770) 429-0083 · Fax (770) 425-0137
Phone(770) 429-0083
Fax(770) 425-0137
Sole ProprietorNo
Medical School CMSKansas City Medical CollegeGraduated 1979
Enumeration DateOctober 2, 2006
Last NPPES UpdateSeptember 30, 2019
✔ NPI 1619060365 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Infectious DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RI0200X
License✔ Licensed in GA · 027663
Definition
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.
55 WHITCHER ST NE, Marietta, GA 30060
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health 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

Dr. Thomas Sheftel 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 ID5193895373
PECOS Enrollment IDI20080530000111
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 8

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 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.
602 services178 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.
184 services111 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.
122 services118 patients
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.
104 services54 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
49 services49 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.
31 services31 patients

Hospital Affiliations CMS Care Compare 2

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

Wellstar Kennestone Regional Medical Center

Acute Care Hospitals · Marietta, GA
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110035
Location677 Church StreetMarietta, GA 30060 · Cobb County
Emergency services Birthing friendly

Wellstar Cobb Medical Center

Acute Care Hospitals · Austell, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110143
Location3950 Austell RdAustell, GA 30106 · Cobb County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30060 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
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

92.93/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.38
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 3

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
6 suppliers11 claims31 services$6.11 avg. paid by Medicare
Male external catheter, with or without adhesive, disposable, each A4349
DME-Medical/Surgical Supplies · category DA000N
1 supplier11 claims352 services$1.51 avg. paid by Medicare
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each A4358
DME-Orthotic Devices · category DF000N
1 supplier11 claims22 services$5.13 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.

DR. ROBERT DAVID JANSEN M.D.
Internal Medicine (Nephrology)
55 WHITCHER ST NE, STE 460
MARIETTA, GA 30060
Cobb County (770) 427-7389
DR. MADHAVI JORDAN MD
Surgery
55 WHITCHER ST NE, SUIT 130
MARIETTA, GA 30060
Cobb County (770) 428-0462
MR. REYES TORRES III PA-C
Physician Assistant
55 WHITCHER ST NE, SUITE 350
MARIETTA, GA 30060
Cobb County (770) 424-6893
ASIF A SABERI M.D.
Internal Medicine (Critical Care Medicine)
55 WHITCHER ST NE, SUITE 160
MARIETTA, GA 30060
Cobb County (770) 422-1372
BRYAN T. PIEDAD M.D.
Internal Medicine (Clinical Cardiac Electrophysiology)
55 WHITCHER ST NE, SUITE 350
MARIETTA, GA 30060
Cobb County (770) 424-6893
MICHAEL J RILEY M.D.
Internal Medicine (Clinical Cardiac Electrophysiology)
55 WHITCHER ST NE, SUITE 350
MARIETTA, GA 30060
Cobb County (770) 424-6893
KAMARA SUZANNE HEARD ACNP
Nurse Practitioner (Acute Care)
55 WHITCHER ST NE
MARIETTA, GA 30060
Cobb County (770) 422-1372
JACLYN WOOD NP
Nurse Practitioner (Family)
55 WHITCHER ST NE, SUITE 250
MARIETTA, GA 30060
Cobb County (770) 428-4475

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 Thomas Sheftel's NPI number?

The NPI number for Thomas Sheftel is 1619060365. It was assigned to this individual provider in the NPPES registry on October 2, 2006.

Where is Thomas Sheftel located?

Thomas Sheftel practices at 55 Whitcher St NE Suite 220, Marietta, GA 30060. The listed phone number is (770) 429-0083.

What is Thomas Sheftel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Infectious Disease, with taxonomy code 207RI0200X.

Is Thomas Sheftel enrolled in Medicare?

Yes. Thomas Sheftel 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 Thomas Sheftel 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 Thomas Sheftel 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 Thomas Sheftel affiliated with any hospitals?

According to CMS data, Thomas Sheftel is affiliated with Wellstar Kennestone Regional Medical Center and Wellstar Cobb Medical Center.

When was this NPI record last updated?

The NPPES record for Thomas Sheftel was last updated on September 30, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.