KETAN VIKRAMBHAI SHAH M.D.
NPI 1790001535
Internal Medicine in Hanover, PA

Q: What is Ketan Shah's NPI number?

The NPI number for Ketan Shah is 1790001535. It was assigned to this individual provider in the NPPES registry on April 19, 2010.

Q: What is Ketan Shah's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Ketan Shah was last updated on December 12, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since April 19, 2010PECOS EnrolledAccepts Medicare Assignment

86.18/100

CMS Quality Rating

300 HIGHLAND AVE, HANOVER, PA 17331(717) 316-3711 Get Directions Write a Review

NPPES record last updated: December 12, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 12, 2020, May 12, 2020, Apr 16, 2020 and 2 more (5 updates tracked since 2019).

On this page

About Ketan Vikrambhai Shah M.d. NPPES

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

KETAN VIKRAMBHAI SHAH M.D. (NPI 1790001535) is an individual internal medicine provider in Hanover, Pennsylvania, licensed in Pennsylvania (MD449148) and active in the NPI registry since April 2010. He is enrolled in Medicare PECOS, is affiliated with Upmc Pinnacle Hospitals, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1790001535

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameKETAN VIKRAMBHAI SHAHCredential: M.D.

Location Address300 HIGHLAND AVEHanover, PA 17331-2297

Mailing Address300 Highland AveHanover, PA 17331-2297 · (717) 316-3711

Phone(717) 316-3711

Sole ProprietorNo

Medical School CMSOtherGraduated 1999

Enumeration DateApril 19, 2010

Last NPPES UpdateDecember 12, 20205 updates tracked since enumeration

NPPES CertifiedDecember 12, 2020

✔ NPI 1790001535 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in PA · MD449148

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.

Also ListedHospitalistTaxonomy 208M00000X · License MD449148 (PA)

300 HIGHLAND AVE, Hanover, PA 17331

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Secondary Practice Locations 2

Location 1501 E Main StWaynesboro, PA 17268-2353 · Phone (717) 765-4000 · Fax (717) 765-3669

Location 2112 N 7th StChambersburg, PA 17201-1720 · Phone (717) 217-4300 · Fax (717) 217-4217

Other Identifiers 1

Medicaid102836582PA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ketan Vikrambhai 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 ID2163665159

PECOS Enrollment IDI20130823000039

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.

Medicare Billing Reassignments

Medicare enrollment records show Ketan Shah reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pinnacle Health Medical Services

Same address

Pediatrics

300 HIGHLAND AVE
Hanover, PA 17331

Reassigned Medicare billing, Pennsylvania enrollment
1,902 clinicians in this Medicare group

NPI 1104385707 (717) 316-3711

Pinnacle Health Hospitalist Services LLC

34 mi

Hospitalist

4300 LONDONDERRY RD
Harrisburg, PA 17109

Reassigned Medicare billing, Pennsylvania enrollment
322 clinicians in this Medicare group

NPI 1023458148 (717) 231-8772

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

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.

522 services248 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.

220 services209 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

210 services201 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.

51 services40 patients

Smoking and tobacco use intensive counseling, 4-10 minutes 99406

This service provides brief, intensive counseling (4-10 minutes) to support you in quitting smoking or tobacco use. It involves discussing the risks of tobacco use, benefits of quitting, and strategies to help you stop. It's a critical step towards a healthier lifestyle.

13 services13 patients

Hospital Affiliations CMS Care Compare 2

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

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 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 17331 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.

86.18/100

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

Scored as part of a group practice

Quality

84.53

Improvement Activities

Cost

65.62

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

2 suppliers21 claims21 services$16.32 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

2 suppliers37 claims37 services$85.25 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.

UPMC HANOVER

Clinical Medical Laboratory