NIRAV N SHAH DO
NPI 1720299340
Internal Medicine - Pulmonary Disease in Freehold, NJ
Active since May 25, 2007PECOS EnrolledAccepts Medicare Assignment
901 W MAIN ST, SUITE 160, CN 5050, FREEHOLD, NJ 07728(732) 577-0600(732) 577-6332 Get Directions Write a Review
About Nirav N Shah Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NIRAV N SHAH DO (NPI 1720299340) is an individual pulmonary disease provider in Freehold, New Jersey, licensed in New Jersey (25MB08017800) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Centrastate Medical Center, and is a graduate of Other (2003).
NPPES Registry Identity
NPI1720299340
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameNIRAV N SHAHCredential: DO
Location Address901 W MAIN ST, SUITE 160, CN 5050Freehold, NJ 07728-2537
Mailing Address901 W Main St, Suite 160, Cn 5050Freehold, NJ 07728-2537 · (732) 577-0600 · Fax (732) 577-6332
Phone(732) 577-0600
Fax(732) 577-6332
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateMay 25, 2007
Last NPPES UpdateApril 6, 2010
✔ NPI 1720299340 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License✔ Licensed in NJ · 25MB08017800
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
901 W MAIN ST, Freehold, NJ 07728
Other Identifiers 6
Medicaid0157481NJ
Other9958326NJ · Aetna Health Plans Ppo
Other6932758NJ · Aetna Health Plans Hmo
OtherP00801247NJ · Medicare Railroad Carrier
Medicare PIN123065AH0NJ
OtherP00746572NJ · Rr Medicare
Accepted Insurance
The full list of accepted plans is on the Insurance tab. Issuers include 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
Nirav N Shah Do 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 ID446337521
PECOS Enrollment IDI20080415000037
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 13
Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Follow-up hospital inpatient care per day, typically 35 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.
570 services314 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.
428 services178 patients
Follow-up hospital inpatient care per day, typically 25 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.
288 services195 patients
Established patient office or other outpatient visit, 30-39 minutes 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.
274 services143 patients
Initial hospital inpatient care per day, typically 50 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.
146 services137 patients
Test to measure expiratory airflow and volume changes before and after medication administration 94060
This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.
117 services117 patients
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Centrastate Medical Center
Acute Care Hospitals · Freehold, NJOwnershipVoluntary non-profit - Private
CMS Certification Number310111
Location901 West Main StreetFreehold, NJ 07728 · Monmouth County
Emergency services Birthing friendly
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 07728 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
$140.34 typical visit price
range $61.59 – $185.05
Typical copayment $35.08 (range $15.39 – $46.26)
Most-billed visit code 99204
Established Patient
$107.94 typical visit price
range $20.08 – $150.98
Typical copayment $26.98 (range $5.02 – $37.74)
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.
Reported Quality Measures
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
20%447 patients1/55-star benchmark: 85%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
69%72 patients3/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
96%1,358 patients4/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
93%1,133 patients4/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
77%289 patients1/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
52%875 patients3/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
28%441 patients2/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
24%753 patients2/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
19%447 patients1/55-star benchmark: 88%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 93% · 405 patients
Patients tobacco: 88% · 405 patients
33%36 patients2/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
26%875 patients2/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
1%875 patients1/55-star benchmark: 89%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period: - Adults aged >= 21 years who were previously diagnosed with or currently have an active…
79%100 patients4/55-star benchmark: 89%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 441 patients
0%441 patients5/55-star benchmark: 100%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
3%875 patients
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.
Referred Medical Equipment & Supplies CMS DME claims 22
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
11 suppliers58 claims58 services$29.42 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
7 suppliers42 claims42 services$69.04 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
8 suppliers45 claims124 services$28.25 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
4 suppliers15 claims86 services$12.58 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
6 suppliers15 claims64 services$12.85 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
10 suppliers47 claims47 services$40.03 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.
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.
Pediatrics (Neonatal-Perinatal Medicine)
901 W MAIN ST
FREEHOLD, NJ 07728
FREEHOLD, NJ 07728
Nurse Practitioner (Adult Health)
901 W MAIN ST, SUITE 106
FREEHOLD, NJ 07728
FREEHOLD, NJ 07728
Nurse Practitioner (Adult Health)
901 W MAIN ST, CENTRASTATE MEDICAL CENTER
FREEHOLD, NJ 07728
FREEHOLD, NJ 07728
Emergency Medicine
901 W MAIN ST, CENTRASTATE MEDICAL CENTER
FREEHOLD, NJ 07728
FREEHOLD, NJ 07728
Emergency Medicine
901 W MAIN ST, CENTRASTATE MEDICAL CENTER
FREEHOLD, NJ 07728
FREEHOLD, NJ 07728
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1720299340, enumerated as an "individual" on May 25, 2007.
The provider is located at 901 W MAIN ST SUITE 160, CN 5050 FREEHOLD, NJ 07728 and the phone number is (732) 577-0600.
Internal Medicine with taxonomy code 207RP1001X and a focus in Pulmonary Disease.
The provider might be accepting Accepts: Ambetter Health, Ambetter Health of Delaware,. Please consult your insurance carrier or call the provider to verify.
Nirav Shah is affiliated with: CENTRASTATE MEDICAL CENTER.
