DR. TUSHAR KANTILAL SHAH M.D.
NPI 1649286360
Internal Medicine in Middleburg Heights, OH

Q: What is Tushar Shah's NPI number?

The NPI number for Tushar Shah is 1649286360. It was assigned to this individual provider in the NPPES registry on August 1, 2006.

Q: What is Tushar Shah's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Tushar Shah was last updated on August 3, 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.

Active since August 01, 2006PECOS EnrolledAccepts Medicare Assignment

90.9/100

CMS Quality Rating

7255 OLD OAK BLVD # C209C, MIDDLEBURG HEIGHTS, OH 44130(440) 816-2777 Get Directions Write a Review

NPPES record last updated: August 3, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 3, 2021, Jan 11, 2021, May 21, 2020 (3 updates tracked since 2020).

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About Dr. Tushar Kantilal Shah M.d. NPPES

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

DR. TUSHAR KANTILAL SHAH M.D. (NPI 1649286360) is an individual internal medicine provider in Middleburg Heights, Ohio, licensed in Ohio (83450) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Parma Community General Hospital, and is a graduate of Other (1992).

NPPES Registry Identity

NPI1649286360

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. TUSHAR KANTILAL SHAHCredential: M.D.

Location Address7255 OLD OAK BLVD # C209CMiddleburg Heights, OH 44130-3329

Mailing Address7255 Old Oak Blvd Ste C209Middleburg Heights, OH 44130-3329 · (440) 816-2777

Phone(440) 816-2777

Sole ProprietorYes

Medical School CMSOtherGraduated 1992

Enumeration DateAugust 1, 2006

Last NPPES UpdateAugust 3, 20213 updates tracked since enumeration

NPPES CertifiedAugust 3, 2021

✔ NPI 1649286360 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in OH · 83450✔ Licensed in OH · 35.083450CTR

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.

Also ListedEmergency MedicineTaxonomy 207P00000X · License 35.083450CTR (OH), 83450 (OH)

7255 OLD OAK BLVD # C209C, Middleburg Heights, OH 44130

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, 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. Tushar Kantilal 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 ID2062312937

PECOS Enrollment IDI20040109000042

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 29

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.

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

383 services127 patients

Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348

An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.

375 services123 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.

326 services220 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.

323 services131 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.

268 services122 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.

242 services225 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

226 services114 patients

Advance care planning, first 30 minutes 99497

220 services184 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.

212 services212 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.

195 services126 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

187 services94 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.

108 services76 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

107 services93 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.

94 services94 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.

86 services74 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

84 services73 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.

80 services26 patients

Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306

An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.

72 services64 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.

62 services59 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

42 services30 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

36 services29 patients

Transitional care management services for problem of high complexity 99496

Transitional care management services are designed to ensure a smooth transition from a hospital to home or another care setting for patients with complex health issues. These services include medication management, patient education, and coordination with healthcare providers.

34 services28 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

26 services26 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

25 services25 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

24 services24 patients

Initial hospital care with same-day admission and discharge with moderate level of medical decision making, per day, if using time, at least 70 minutes 99235

This service involves a brief hospital stay for a moderate health issue. You'll be admitted and discharged on the same day, typically within 50 minutes. It's a quick, efficient way to receive necessary care and medical attention.

21 services20 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

15 services15 patients

Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes 99344

A new patient home visit is a comprehensive service where a healthcare professional visits your home for about an hour. This visit includes an overall health assessment, discussion about your medical history, and planning for future healthcare needs. The goal is to understand your health status and provide personalized care.

14 services14 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.

12 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Parma Community General Hospital

Acute Care Hospitals · Parma, OH

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360041

Location7007 Powers BoulevardParma, OH 44129 · Cuyahoga County

Southwest General Health Center

Acute Care Hospitals · Middleburg Heights, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360155

Location18697 Bagley RoadMiddleburg Heights, OH 44130 · Cuyahoga County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44130 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

$126.12 typical visit price

range $54.34 – $166.65

Typical copayment $31.53 (range $13.58 – $41.66)

Most-billed visit code 99204

Established Patient

$96.44 typical visit price

range $17.10 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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.

90.9/100

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

Scored through an Alternative Payment Model

Quality

81.8

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 6

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

8 suppliers22 claims58 services$6.56 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

5 suppliers12 claims20 services$1.11 avg. paid by Medicare

Tape, waterproof, per 18 square inches A4452

DME-Medical/Surgical Supplies · category DA000N

1 supplier12 claims1,040 services$0.37 avg. paid by Medicare

Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing A6252

DME-Medical/Surgical Supplies · category DA023N

1 supplier15 claims189 services$2.96 avg. paid by Medicare

Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard A6446

DME-Medical/Surgical Supplies · category DA023N

1 supplier14 claims596 services$0.37 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

4 suppliers16 claims16 services$64.12 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Tushar Shah's NPI number?

The NPI number for Tushar Shah is 1649286360. It was assigned to this individual provider in the NPPES registry on August 1, 2006.

Where is Tushar Shah located?

Tushar Shah practices at 7255 Old Oak Blvd # C209c, Middleburg Heights, OH 44130. The listed phone number is (440) 816-2777.

What is Tushar Shah's specialty?

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

Is Tushar Shah enrolled in Medicare?

Yes. Tushar 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 Tushar Shah accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Antidote Health Plan of Ohio, Inc. and CareSource and 3 other insurers list Tushar 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 Tushar Shah affiliated with any hospitals?

According to CMS data, Tushar Shah is affiliated with Parma Community General Hospital and Southwest General Health Center.

When was this NPI record last updated?

The NPPES record for Tushar Shah was last updated on August 3, 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.