SHEFALI SHAH M.D.
NPI 1720469950
Internal Medicine - Gastroenterology in Oakhurst, NJ

Q: What is Shefali Shah's NPI number?

The NPI number for Shefali Shah is 1720469950. It was assigned to this individual provider in the NPPES registry on June 12, 2015.

Q: What is Shefali Shah's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Shefali Shah was last updated on March 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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 June 12, 2015PECOS EnrolledAccepts Medicare Assignment

97.45/100

CMS Quality Rating

1912 STATE ROUTE 35 STE 201, OAKHURST, NJ 07755(732) 389-5004 Get Directions Write a Review

NPPES record last updated: March 6, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Shefali Shah M.d. NPPES

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

SHEFALI SHAH M.D. (NPI 1720469950) is an individual gastroenterology provider in Oakhurst, New Jersey, licensed in New Jersey (25MA11237700) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS, is affiliated with Jersey Shore University Medical Center, and maintains a secondary practice location in Philadelphia.

NPPES Registry Identity

NPI1720469950

Entity TypeIndividualFemale

Primary Taxonomy207RG0100X

Provider Legal NameSHEFALI SHAHCredential: M.D.

Location Address1912 STATE ROUTE 35 STE 201Oakhurst, NJ 07755-2768

Mailing Address187 Route 36 Ste 230West Long Branch, NJ 07764-1306 · (732) 222-3805 · Fax (215) 762-7765

Phone(732) 389-5004

Sole ProprietorYes

Medical School CMSDrexel University College Of MedicineGraduated 2015

Enumeration DateJune 12, 2015

Last NPPES UpdateMarch 6, 2025

NPPES CertifiedMarch 6, 2025

✔ NPI 1720469950 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in NJ · 25MA11237700

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

Also ListedInternal MedicineTaxonomy 207R00000X · License S31427047559882 (NJ)

1912 STATE ROUTE 35 STE 201, Oakhurst, NJ 07755

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Secondary Practice Location 1

Location 1245 N 15th St, 6th FloorPhiladelphia, PA 19102-1101 · Phone (215) 762-7916 · Fax (215) 762-7765

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

Shefali 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 ID2264794759

PECOS Enrollment IDI20211030000052

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 12

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 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.

185 services111 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.

124 services79 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.

104 services78 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

90 services79 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.

82 services81 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.

59 services47 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

46 services45 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.

35 services35 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.

30 services24 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

22 services22 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

18 services18 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

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.

Jersey Shore University Medical Center

Acute Care Hospitals · Neptune, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310073

Location1945 State Route 33Neptune, NJ 07753 · Monmouth County

Emergency services Birthing friendly

Monmouth Medical Center

Acute Care Hospitals · Long Branch, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310075

Location300 Second AvenueLong Branch, NJ 07740 · Monmouth County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07755 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.

97.45/100

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

Scored as part of a group practice

Promoting Interoperability

Improvement Activities

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHRYN JULIA BACCI

Physician Assistant

1912 STATE ROUTE 35 STE 201
OAKHURST, NJ 07755

Monmouth County (732) 389-5004

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 Shefali Shah's NPI number?

The NPI number for Shefali Shah is 1720469950. It was assigned to this individual provider in the NPPES registry on June 12, 2015.

Where is Shefali Shah located?

Shefali Shah practices at 1912 State Route 35 Ste 201, Oakhurst, NJ 07755. The listed phone number is (732) 389-5004.

What is Shefali Shah's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Shefali Shah enrolled in Medicare?

Yes. Shefali 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 Shefali Shah accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Shefali 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 Shefali Shah affiliated with any hospitals?

According to CMS data, Shefali Shah is affiliated with Jersey Shore University Medical Center and Monmouth Medical Center.

When was this NPI record last updated?

The NPPES record for Shefali Shah was last updated on March 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.