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DR. SEJAL SHAH M.D.
NPI 1649201039
Internal Medicine in Oak Park, IL

Active since July 05, 2006PECOS EnrolledAccepts Medicare Assignment
84.57/100
CMS Quality Rating
610 S MAPLE AVE, SUITE 3440, OAK PARK, IL 60304(708) 660-5017 Get Directions Write a Review

NPPES record last updated: April 30, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Apr 30, 2021, Oct 24, 2019 (2 updates tracked since 2019).

About Dr. Sejal Shah M.d. NPPES

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

DR. SEJAL SHAH M.D. (NPI 1649201039) is an individual internal medicine provider in Oak Park, Illinois, licensed in Illinois (036-110950) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with John H Stroger Jr Hospital, and is a graduate of Other (2001).

NPPES Registry Identity

NPI1649201039
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. SEJAL SHAHCredential: M.D.
Location Address610 S MAPLE AVE, SUITE 3440Oak Park, IL 60304-1091
Mailing Address610 S Maple Ave Ste 3440Oak Park, IL 60304-2804 · (708) 680-6449
Phone(708) 660-5017
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateJuly 5, 2006
Last NPPES UpdateApril 30, 20212 updates tracked since enumeration
NPPES CertifiedApril 30, 2021
✔ NPI 1649201039 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 036-110950
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.
610 S MAPLE AVE, Oak Park, IL 60304
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.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. Sejal 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 ID1153324405
PECOS Enrollment IDI20060807000362
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 2

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.

Anticoagulant management of patient taking warfarin 93793
Anticoagulant management with warfarin involves monitoring and adjusting your medication to prevent blood clots while minimizing the risk of bleeding. Regular blood tests measure your response to warfarin, helping adjust your dose if necessary. It's crucial to maintain a consistent diet and promptly report any changes in your health.
64 services37 patients
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.
17 services17 patients

Hospital Affiliations CMS Care Compare

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

John H Stroger Jr Hospital

Acute Care Hospitals · Chicago, IL
2/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number140124
Location1901 W Harrison StChicago, IL 60612 · Cook County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60304 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
$138.86 typical visit price
range $60.08 – $183.39
Typical copayment $34.71 (range $15.02 – $45.84)
Most-billed visit code 99204
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
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.

84.57/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality60.25
Promoting Interoperability100
Improvement Activities40
Cost67

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.

ASHLEY SERFILIPPI
Student in an Organized Health Care Education/Training Program
610 S MAPLE AVE
OAK PARK, IL 60304
Cook County (708) 660-4300
HEALTH DELIVERY MANAGEMENT, LLC
Pharmacy (Community/Retail Pharmacy)
610 S MAPLE AVE, SUITE 1600
OAK PARK, IL 60304
Cook County (708) 660-6822
BRENDAN NAMOFF
Nurse Anesthetist, Certified Registered
610 S MAPLE AVE
OAK PARK, IL 60304
Cook County (312) 942-5000
MIDWEST GI AND HEPATOLOGY, LLC
Internal Medicine (Gastroenterology)
610 S MAPLE AVE, SUITE 2600
OAK PARK, IL 60304
Cook County (708) 290-1010
DR. BERNARD L CONIGLIO JR. M.D.
Internal Medicine
610 S MAPLE AVE, SUITE 2100
OAK PARK, IL 60304
Cook County (708) 660-2240
ENCOUNTER MEDICAL GROUP, P.C.
Community/Behavioral Health
610 S MAPLE AVE, SUITE 3400
OAK PARK, IL 60304
Cook County (708) 613-4750
DR. JUDY A CARTER M.D.
Internal Medicine (Endocrinology, Diabetes & Metabolism)
610 S MAPLE AVE, SUITE 2100
OAK PARK, IL 60304
Cook County (708) 660-2240
RUSH PRESBYTERIAN ST. LUKES MEDICAL CENTER
Internal Medicine
610 S MAPLE AVE, SUITE 3900
OAK PARK, IL 60304
Cook County (708) 524-1674

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 Sejal Shah's NPI number?

The NPI number for Sejal Shah is 1649201039. It was assigned to this individual provider in the NPPES registry on July 5, 2006.

Where is Sejal Shah located?

Sejal Shah practices at 610 S Maple Ave Suite 3440, Oak Park, IL 60304. The listed phone number is (708) 660-5017.

What is Sejal Shah's specialty?

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

Is Sejal Shah enrolled in Medicare?

Yes. Sejal 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.

What insurance does Sejal Shah accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Sejal 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.

Is Sejal Shah affiliated with any hospitals?

According to CMS data, Sejal Shah is affiliated with John H Stroger Jr Hospital.

When was this NPI record last updated?

The NPPES record for Sejal Shah was last updated on April 30, 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.