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KETANKUMAR SHAH MD
NPI 1659761948
Internal Medicine in Edison, NJ

Active since January 26, 2015PECOS EnrolledAccepts Medicare Assignment
92.22/100
CMS Quality Rating
608 CINDER RD, EDISON, NJ 08820(732) 429-5499 Get Directions Write a Review

NPPES record last updated: September 1, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ketankumar Shah Md NPPES

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

KETANKUMAR SHAH MD (NPI 1659761948) is an individual internal medicine provider in Edison, New Jersey, licensed in Connecticut (054281) and active in the NPI registry since January 2015. He is enrolled in Medicare PECOS, is affiliated with Jfk Medical Center, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1659761948
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameKETANKUMAR SHAHCredential: MD
Location Address608 CINDER RDEdison, NJ 08820-3373
Mailing Address608 Cinder RdEdison, NJ 08820-3373 · (732) 429-5499
Phone(732) 429-5499
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateJanuary 26, 2015
Last NPPES UpdateSeptember 1, 2015
✔ NPI 1659761948 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CT · 054281
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.
608 CINDER RD, Edison, NJ 08820
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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

Ketankumar 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 ID7113235011
PECOS Enrollment IDI20150925001565, I20160122000709
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 4

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.
452 services157 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.
60 services57 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.
58 services57 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.
26 services26 patients

Hospital Affiliations CMS Care Compare

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

Jfk Medical Center

Acute Care Hospitals · Edison, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310108
Location65 James StreetEdison, NJ 08820 · Middlesex County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08820 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
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
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.

92.22/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality92.15
Promoting Interoperability100
Improvement Activities40
Cost58.82

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.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier13 claims13 services$13.79 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
1 supplier13 claims13 services$63.87 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 Ketankumar Shah's NPI number?

The NPI number for Ketankumar Shah is 1659761948. It was assigned to this individual provider in the NPPES registry on January 26, 2015.

Where is Ketankumar Shah located?

Ketankumar Shah practices at 608 Cinder Rd, Edison, NJ 08820. The listed phone number is (732) 429-5499.

What is Ketankumar Shah's specialty?

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

Is Ketankumar Shah enrolled in Medicare?

Yes. Ketankumar 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.

Is Ketankumar Shah affiliated with any hospitals?

According to CMS data, Ketankumar Shah is affiliated with Jfk Medical Center.

When was this NPI record last updated?

The NPPES record for Ketankumar Shah was last updated on September 1, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.