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SHETAL H. PADIA MD
NPI 1679797302
Internal Medicine - Endocrinology, Diabetes & Metabolism in York, PA

Active since April 12, 2007PECOS EnrolledAccepts Medicare Assignment
82.54/100
CMS Quality Rating
1600 6TH AVE STE 102, YORK, PA 17403(717) 849-5500(717) 472-8282 Get Directions Write a Review

NPPES record last updated: May 8, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 8, 2023, Dec 9, 2022, Dec 1, 2022 and 1 more (4 updates tracked since 2016).

About Shetal H. Padia Md NPPES

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

SHETAL H. PADIA MD (NPI 1679797302) is an individual endocrinology, diabetes & metabolism provider in York, Pennsylvania, licensed in Pennsylvania (MD479771) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS, is affiliated with Wellspan York Hospital, and maintains a secondary practice location in Charlottesville.

NPPES Registry Identity

NPI1679797302
Entity TypeIndividualFemale
Primary Taxonomy207RE0101X
Provider Legal NameSHETAL H. PADIACredential: MD
Location Address1600 6TH AVE STE 102York, PA 17403-2626
Mailing AddressPo Box 9007Charlottesville, VA 22906-9007
Phone(717) 849-5500
Fax(717) 472-8282
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateApril 12, 2007
Last NPPES UpdateMay 8, 20234 updates tracked since enumeration
NPPES CertifiedMay 8, 2023
✔ NPI 1679797302 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in PA · MD479771
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
1600 6TH AVE STE 102, York, PA 17403
Open in Google Maps ↗

Secondary Practice Location 1

Location 1415 Ray C. Hunt DriveCharlottesville, VA 22903 · Phone (434) 924-1825 · Fax (434) 982-3628

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

Shetal H. Padia 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 ID9931196193
PECOS Enrollment IDI20221221001653
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 5

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.

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.
180 services114 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.
47 services47 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
32 services20 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.
19 services18 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.
19 services16 patients

Hospital Affiliations CMS Care Compare 5

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

Wellspan York Hospital

Acute Care Hospitals · York, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390046
Location1001 South George StreetYork, PA 17403 · York County
Emergency services Birthing friendly

Upmc Pinnacle Hospitals

Acute Care Hospitals · Harrisburg, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390067
Location409 South Second StreetHarrisburg, PA 17104 · Dauphin County
Emergency services Birthing friendly

Upmc Lititz

Acute Care Hospitals · Lititz, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390068
Location1500 Highlands DriveLititz, PA 17543 · Lancaster County
Emergency services Birthing friendly

Upmc Memorial

Acute Care Hospitals · York, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390101
Location1701 Innovation DriveYork, PA 17408 · York County
Emergency services Birthing friendly

Upmc Hanover

Acute Care Hospitals · Hanover, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390233
Location300 Highland AveHanover, PA 17331 · York County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 17403 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

82.54/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality76.62
Promoting Interoperability100
Improvement Activities40
Cost65.18

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
3 suppliers33 claims34 services$180.27 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 Shetal Padia's NPI number?

The NPI number for Shetal Padia is 1679797302. It was assigned to this individual provider in the NPPES registry on April 12, 2007.

Where is Shetal Padia located?

Shetal Padia practices at 1600 6th Ave Ste 102, York, PA 17403. The listed phone number is (717) 849-5500.

What is Shetal Padia's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Shetal Padia enrolled in Medicare?

Yes. Shetal Padia 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 Shetal Padia affiliated with any hospitals?

According to CMS data, Shetal Padia is affiliated with Wellspan York Hospital, Upmc Pinnacle Hospitals, Upmc Lititz, Upmc Memorial and Upmc Hanover.

When was this NPI record last updated?

The NPPES record for Shetal Padia was last updated on May 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.