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MR. SHANE SAMUEL VARGHESE M.D.
NPI 1851747372
Hospitalist in Rochester, NY

Active since May 13, 2016PECOS EnrolledAccepts Medicare Assignment
81.38/100
CMS Quality Rating
1425 PORTLAND AVE, ROCHESTER, NY 14621(585) 922-5067 Get Directions Write a Review

NPPES record last updated: January 17, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 3, 2023, Jan 10, 2017, May 13, 2016 (3 updates tracked since 2016).

About Mr. Shane Samuel Varghese M.d. NPPES

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

MR. SHANE SAMUEL VARGHESE M.D. (NPI 1851747372) is an individual hospitalist provider in Rochester, New York, licensed in New York (301310) and active in the NPI registry since May 2016. He is enrolled in Medicare PECOS, is affiliated with Rochester General Hospital, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1851747372
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameMR. SHANE SAMUEL VARGHESECredential: M.D.
Location Address1425 PORTLAND AVERochester, NY 14621-3011
Mailing Address100 Kings Hwy SRochester, NY 14617-5504 · (585) 922-1900
Phone(585) 922-5067
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateMay 13, 2016
Last NPPES UpdateJanuary 17, 20243 updates tracked since enumeration
NPPES CertifiedJanuary 17, 2024
✔ NPI 1851747372 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in NY · 301310
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License 301310 (NY)
1425 PORTLAND AVE, Rochester, NY 14621
Open in Google Maps ↗

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

Mr. Shane Samuel Varghese 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 ID1951648245
PECOS Enrollment IDI20191031002322
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 4

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.
174 services74 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.
120 services52 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.
46 services43 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.
23 services23 patients

Hospital Affiliations CMS Care Compare 2

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

Rochester General Hospital

Acute Care Hospitals · Rochester, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330125
Location1425 Portland AvenueRochester, NY 14621 · Monroe County
Emergency services Birthing friendly

Unity Hospital

Acute Care Hospitals · Rochester, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330226
Location1555 Long Pond RoadRochester, NY 14626 · Monroe County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14621 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
$126.40 typical visit price
range $54.87 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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.

81.38/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality66.88
Promoting Interoperability100
Improvement Activities40
Cost61.7

Referred Medical Equipment & Supplies CMS DME claims 5

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 suppliers16 claims16 services$16.03 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
1 supplier21 claims21 services$918.60 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier20 claims20 services$7.82 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 suppliers50 claims50 services$107.66 avg. paid by Medicare
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738
DME-Oxygen and Supplies · category DC000N
1 supplier23 claims23 services$36.56 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.

DR. NIAZ AHMED D.D.S.
Dentist
1425 PORTLAND AVE
ROCHESTER, NY 14621
Monroe County (585) 922-4000
DR. BRIAN JOHN THOMAS D.O.
Anesthesiology
1425 PORTLAND AVE
ROCHESTER, NY 14621
Monroe County (585) 922-4159
LISA NICOLE FRONCZAK PA-C
Physician Assistant
1425 PORTLAND AVE, BOX 362
ROCHESTER, NY 14621
Monroe County (585) 922-4000
ANDREW ROTANDO DO
Emergency Medicine
1425 PORTLAND AVE
ROCHESTER, NY 14621
Monroe County (585) 922-3469
ALEXANDER VAZZANO MD
Emergency Medicine
1425 PORTLAND AVE
ROCHESTER, NY 14621
Monroe County (585) 922-4638
AMY BODROG MD
Internal Medicine (Hematology)
1425 PORTLAND AVE
ROCHESTER, NY 14621
Monroe County (585) 922-4020
NUMRA ASLAM BAJWA MD
Hospitalist
1425 PORTLAND AVE
ROCHESTER, NY 14621
Monroe County (585) 922-5067
DR. PRAKASH UPRETI MD
Hospitalist
1425 PORTLAND AVE
ROCHESTER, NY 14621
Monroe County (295) 029-8769

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 Shane Varghese's NPI number?

The NPI number for Shane Varghese is 1851747372. It was assigned to this individual provider in the NPPES registry on May 13, 2016.

Where is Shane Varghese located?

Shane Varghese practices at 1425 Portland Ave, Rochester, NY 14621. The listed phone number is (585) 922-5067.

What is Shane Varghese's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Shane Varghese enrolled in Medicare?

Yes. Shane Varghese 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.

Is Shane Varghese affiliated with any hospitals?

According to CMS data, Shane Varghese is affiliated with Rochester General Hospital and Unity Hospital.

When was this NPI record last updated?

The NPPES record for Shane Varghese was last updated on January 17, 2024. 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.