DR. NIRMAL SHAH D.O.
NPI 1770966707
Anesthesiology in Allentown, PA

Medicare Participation & PECOS Enrollment Status

Nirmal Shah is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Nirmal Shah is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

• Is the provider registered in PECOS? Yes

• PECOS PAC ID: 2668781063

  What is the PECOS Associate Control ID?
  A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

• PECOS Enrollment ID: I20200715002131, I20210712001984

  What is the Provider Enrollment ID?
  The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

• Accepts Medicare Assignment? Yes

  What does it mean "accepts medicare assignment"?
  When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
  A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

• Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

• Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

• Eligible to Order or Refer a Home Health Agency (HHA): Yes

• Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 382 times for 201 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

This service was performed 15 times for 15 patients

Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance

This procedure involves injecting medicine into the joint where your lower spine meets your hip bone. Using special imaging technology, the doctor ensures the medicine is delivered accurately. This can help reduce pain and inflammation in that area.

This service was performed 28 times for 24 patients

Injection of lower or sacral spine facet joint using imaging guidance, second level

This procedure involves injecting medication into the facet joints of your lower or sacral spine to manage pain. Imaging guidance ensures accurate placement. It's the second level, meaning it's done on two different joint levels.

This service was performed 24 times for 20 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level

This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.

This service was performed 24 times for 20 patients

Injection of substance into lower spine canal using imaging guidance

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

This service was performed 115 times for 96 patients

Injection of substance into middle or upper spine canal using imaging guidance

This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.

This service was performed 12 times for 11 patients

New patient office or other outpatient visit, 45-59 minutes

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.

This service was performed 156 times for 156 patients

Removal of bone from lower spine for decompression of nerve tissue using imaging guidance, accessed through the skin

This procedure involves removing a small portion of bone from your lower spine. The goal is to relieve pressure on your nerve tissue, improving comfort and mobility. It is done through the skin using imaging technology to ensure precision and safety.

This service was performed 17 times for 17 patients

Spinal fusion

Spinal fusion is a surgical procedure aimed at connecting two or more vertebrae in your spine to reduce pain and improve stability. It involves using a bone graft to cause the vertebrae to grow together, limiting the movement between them. This procedure is often performed to treat conditions like herniated discs or spinal stenosis.

This service was performed for 1-10 patients

Telephone medical discussion with physician, 11-20 minutes

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

This service was performed 85 times for 67 patients

Telephone medical discussion with physician, 21-30 minutes

This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.

This service was performed 36 times for 29 patients

X-ray of joint between lower spine and hip bone, 3 or more views

This procedure involves taking X-ray images of the joint connecting your lower spine and hip bone from three or more angles. It helps in diagnosing conditions like arthritis or fractures. You'll be positioned carefully, and the X-ray machine will capture the images.

This service was performed 32 times for 32 patients

X-ray of lower and sacral spine, minimum of 4 views

An X-ray of the lower and sacral spine involves capturing images of your lower back and tailbone area. It helps in identifying issues like fractures, arthritis, or other abnormalities. At least four different angles or 'views' are taken to get a comprehensive picture.

This service was performed 42 times for 40 patients

X-ray of middle spine, 2 views

An X-ray of the middle spine, or thoracic spine, involves capturing two different images of the area. This non-invasive procedure uses small amounts of radiation to visualize the bones and tissues in your back, helping to identify any abnormalities or injuries.

This service was performed 12 times for 12 patients

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Nirmal Shah is affiliated with the following medical facilities:

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