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POOJA S SHAH PA-C
NPI 1831729730
Physician Assistant in Madison, WI

Active since January 19, 2020PECOS EnrolledAccepts Medicare Assignment
95.84/100
CMS Quality Rating
752 N HIGH POINT RD, MADISON, WI 53717(608) 824-4000(608) 824-4949 Get Directions Write a Review

NPPES record last updated: December 11, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 11, 2023, Dec 7, 2023, May 12, 2021 and 2 more (5 updates tracked since 2020).

About Pooja S Shah Pa-c NPPES

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

POOJA S SHAH PA-C (NPI 1831729730) is an individual physician assistant in Madison, Wisconsin, licensed in Wisconsin (5938-23) and active in the NPI registry since January 2020. She is enrolled in Medicare PECOS, is affiliated with Ssm Health St Mary's Hospital - Madison, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1831729730
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NamePOOJA S SHAHCredential: PA-C
Location Address752 N HIGH POINT RDMadison, WI 53717-2236
Mailing Address752 N High Point RdMadison, WI 53717-2236 · (608) 824-4000 · Fax (608) 824-4949
Phone(608) 824-4000
Fax(608) 824-4949
Sole ProprietorYes
Medical School CMSOtherGraduated 2020
Enumeration DateJanuary 19, 2020
Last NPPES UpdateDecember 11, 20235 updates tracked since enumeration
NPPES CertifiedDecember 11, 2023
✔ NPI 1831729730 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in WI · 5938-23
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
752 N HIGH POINT RD, Madison, WI 53717
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Texas, Oscar Insurance Company.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

Pooja S Shah Pa-c 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 ID6800290941
PECOS Enrollment IDI20231130000647
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 10

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.

Destruction of precancer skin growth, 2-14 growths 17003
This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.
732 services139 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.
348 services276 patients
Destruction of precancer skin growth, 1 growth 17000
"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.
236 services183 patients
Biopsy of related skin growth, first growth 11102
A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.
140 services118 patients
Destruction of skin growth, 1-14 growths 17110
"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.
77 services67 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.
66 services56 patients

Hospital Affiliations CMS Care Compare

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

Ssm Health St Mary's Hospital - Madison

Acute Care Hospitals · Madison, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520083
Location700 South Park StMadison, WI 53715 · Dane County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53717 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
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.

95.84/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality89.6
Improvement Activities40
Cost100

Patient Reviews User submitted

Reviews are submitted by site visitors and approved by a human moderator before publication.

Review by Charlene ***** March 18, 2025

5/5
I highly recommend this amazing determatologist! She cares about the wellbeing of her patients. She is highly intelligent and very kind! She is very professionall, yet very personable. I have great respect for her and trust her medical opinion.
Provider 5/5 Office Staff 5/5
Visited this provider? Share your experience.

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.

HEATHER L MUCKLER COTA
Occupational Therapy Assistant
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4821
DR. MINDY BAUER PHARMD
Pharmacist
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4500
DAVID K FALK MD
Dermatology
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4000
DAVID A SORBER MD
Internal Medicine
752 N HIGH POINT RD, DEAN MEDICAL CENTER
MADISON, WI 53717
Dane County (608) 824-4800
JULIA L. THORSEN M.D.
Allergy & Immunology
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4000
SARAH A OLIVER PA-C
Physician Assistant
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4000
DR. GRANT MACAULAY M.D.
Internal Medicine
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4000
DR. JUI B HAKER MD
Preventive Medicine (Occupational Medicine)
752 N HIGH POINT RD
MADISON, WI 53717
Dane County (608) 824-4000

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 Pooja Shah's NPI number?

The NPI number for Pooja Shah is 1831729730. It was assigned to this individual provider in the NPPES registry on January 19, 2020.

Where is Pooja Shah located?

Pooja Shah practices at 752 N High Point Rd, Madison, WI 53717. The listed phone number is (608) 824-4000.

What is Pooja Shah's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Pooja Shah enrolled in Medicare?

Yes. Pooja 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 Pooja Shah accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Texas and Oscar Insurance Company list Pooja 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 Pooja Shah affiliated with any hospitals?

According to CMS data, Pooja Shah is affiliated with Ssm Health St Mary's Hospital - Madison.

When was this NPI record last updated?

The NPPES record for Pooja Shah was last updated on December 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.