DR. KETAN K SHAH M.D., M.B.A.
NPI 1629244652
Internal Medicine - Gastroenterology in Orange, CA

Q: What is Ketan Shah's NPI number?

The NPI number for Ketan Shah is 1629244652. It was assigned to this individual provider in the NPPES registry on April 30, 2008.

Q: What is Ketan Shah's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Ketan Shah was last updated on August 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.

Active since April 30, 2008PECOS EnrolledAccepts Medicare Assignment

61.51/100

CMS Quality Rating

1100 W TOWN AND COUNTRY RD STE 1250, ORANGE, CA 92868(949) 744-5441(949) 266-1661 Get Directions Write a Review

NPPES record last updated: August 18, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Feb 6, 2024, Dec 14, 2023 (2 updates tracked since 2023).

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About Dr. Ketan K Shah M.d., M.b.a. NPPES

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

DR. KETAN K SHAH M.D., M.B.A. (NPI 1629244652) is an individual gastroenterology provider in Orange, California, licensed in California (A120437) and active in the NPI registry since April 2008. He is enrolled in Medicare PECOS, maintains a secondary practice location in Santa Ana, and is a graduate of Duke University School Of Medicine (2012).

NPPES Registry Identity

NPI1629244652

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameDR. KETAN K SHAHCredential: M.D., M.B.A.

Location Address1100 W TOWN AND COUNTRY RD STE 1250Orange, CA 92868-4633

Mailing Address1100 W Town And Country Rd Ste 1250Orange, CA 92868-4633 · (949) 744-5441 · Fax (949) 266-1661

Phone(949) 744-5441

Fax(949) 266-1661

Sole ProprietorNo

Medical School CMSDuke University School Of MedicineGraduated 2012

Enumeration DateApril 30, 2008

Last NPPES UpdateAugust 18, 20252 updates tracked since enumeration

NPPES CertifiedAugust 18, 2025

✔ NPI 1629244652 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in CA · A120437

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Also ListedInternal MedicineTaxonomy 207R00000X · License A120437 (CA)

1100 W TOWN AND COUNTRY RD STE 1250, Orange, CA 92868

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Secondary Practice Location 1

Location 11206 E 17th St Ste 101Santa Ana, CA 92701-2641 · Phone (714) 352-2911 · Fax (714) 352-2903

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. Ketan K Shah M.d., M.b.a. 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 ID3274847272

PECOS Enrollment IDI20150804006312

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 3

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.

28 services15 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

27 services19 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92868 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

$142.39 typical visit price

range $62.96 – $187.60

Typical copayment $35.59 (range $15.74 – $46.90)

Most-billed visit code 99204

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

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.

61.51/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

56.72

Promoting Interoperability

Improvement Activities

Cost

19.97

Reported Quality Measures

Breast Cancer Screening

4%230 patients1/55-star benchmark: 93%

Colorectal Cancer Screening

90%452 patients5/55-star benchmark: 88%

Controlling High Blood Pressure

53%106 patients3/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

69%1,179 patients3/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

13%372 patients1/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

39%66 patients2/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

3%693 patients1/55-star benchmark: 97%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

31%42 patients3/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients screened: 94% · 325 patients

93%325 patients

Provide Patients Electronic Access to Their Health Information

92%157 patients4/55-star benchmark: 100%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 2% · 389 patients

Patients totalRate: 5% · 389 patients

5%389 patients4/55-star benchmark: 100%

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.

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.

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