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PRATIK SHAH M.D.
NPI 1871977793
Internal Medicine - Endocrinology, Diabetes & Metabolism in Frederick, MD

Active since July 10, 2015PECOS EnrolledAccepts Medicare Assignment
80.25/100
CMS Quality Rating
7211 BANK CT, FREDERICK, MD 21703(240) 566-7830 Get Directions Write a Review

NPPES record last updated: August 12, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 12, 2026, Jul 27, 2020 (2 updates tracked since 2020).

About Pratik Shah M.d. NPPES

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

PRATIK SHAH M.D. (NPI 1871977793) is an individual endocrinology, diabetes & metabolism provider in Frederick, Maryland, licensed in New Jersey (25MA13211100) and active in the NPI registry since July 2015. He is enrolled in Medicare PECOS, is affiliated with Frederick Health Hospital, and maintains a secondary practice location in Camden.

NPPES Registry Identity

NPI1871977793
Entity TypeIndividualMale
Primary Taxonomy207RE0101X
Provider Legal NamePRATIK SHAHCredential: M.D.
Location Address7211 BANK CTFrederick, MD 21703-8483
Mailing AddressPo Box 37086Baltimore, MD 21297-3086 · (240) 439-8812
Phone(240) 566-7830
Sole ProprietorYes
Medical School CMSDrexel University College Of MedicineGraduated 2015
Enumeration DateJuly 10, 2015
Last NPPES UpdateAugust 12, 20262 updates tracked since enumeration
NPPES CertifiedAugust 12, 2026
✔ NPI 1871977793 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
Licenses✔ Licensed in NJ · 25MA13211100✔ Licensed in MD · D89673
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
7211 BANK CT, Frederick, MD 21703
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Secondary Practice Location 1

Location 11 Cooper PlzCamden, NJ 08103-1461 · Phone (856) 342-2000

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

Pratik 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 ID3971858572
PECOS Enrollment IDI20200729003732
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

2

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

Frederick Health Medical Group LLC
Same address
Family Medicine
7211 BANK CT STE 200
Frederick, MD 21703
  • Reassigned Medicare billing, Maryland enrollment
  • 245 clinicians in this Medicare group
NPI 1578362836 (240) 215-6310
Manalapan Medical Center PA PC
174 mi
Endocrinology, Diabetes & Metabolism
345 ROUTE 9 SOUTH, SUITE 9
Manalapan, NJ 07726
  • Reassigned Medicare billing, New Jersey enrollment
  • 24 clinicians in this Medicare group
NPI 1821225137 (732) 845-2200

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 6

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.

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.
413 services288 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
295 services180 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
170 services83 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
46 services46 patients
Ultrasound scan of head and neck soft tissue 76536
An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.
36 services35 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.
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.

Frederick Health Hospital

Acute Care Hospitals · Frederick, MD
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number210005
Location400 West Seventh StFrederick, MD 21701 · Frederick County
Emergency services Birthing friendly

Jefferson Medical Center

Critical Access Hospitals · Ranson, WV
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number511319
Location300 South Preston StreetRanson, WV 25438 · Jefferson County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21703 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
$133.05 typical visit price
range $57.99 – $175.57
Typical copayment $33.26 (range $14.49 – $43.89)
Most-billed visit code 99204
Established Patient
$102.11 typical visit price
range $18.66 – $143.02
Typical copayment $25.52 (range $4.66 – $35.75)
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.

80.25/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.29
Promoting Interoperability100
Improvement Activities40
Cost54.89

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.

Supplies for maintenance of insulin infusion catheter, per week A4224
DME-Other DME · category DE017N
2 suppliers23 claims290 services$18.29 avg. paid by Medicare
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
DME-Other DME · category DE017N
2 suppliers23 claims730 services$2.35 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
29 suppliers68 claims297 services$5.87 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
10 suppliers18 claims40 services$1.13 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
19 suppliers216 claims216 services$178.88 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. KRISTIN A CONLEY DO
Internal Medicine
7211 BANK CT
FREDERICK, MD 21703
Frederick County (240) 566-7830
KATHERINE N FIELDS RD, CDE
Dietitian, Registered
7211 BANK CT, SUITE 240
FREDERICK, MD 21703
Frederick County (240) 215-1454
MR. DANIEL CHRISTOPHER ROSKO PA-C
Physician Assistant (Medical)
7211 BANK CT
FREDERICK, MD 21703
Frederick County (240) 215-1420
BROOKE ANN VELASQUEZ PA-C
Physician Assistant
7211 BANK CT
FREDERICK, MD 21703
Frederick County (240) 215-6310
MARCIA WOLFINGER
Counselor (Mental Health)
7211 BANK CT
FREDERICK, MD 21703
Frederick County (240) 566-7830
MRS. MICHELLE RAE SHAFFER MPA-C
Physician Assistant (Medical)
7211 BANK CT
FREDERICK, MD 21703
Frederick County (240) 215-6370
MRS. JOANNA EATON MSPH, RDN, LDN
Dietitian, Registered
7211 BANK CT, SUITE 240
FREDERICK, MD 21703
Frederick County (240) 215-1474
DR. LEV AGARUNOV M.D.
Internal Medicine (Pulmonary Disease)
7211 BANK CT
FREDERICK, MD 21703
Frederick County (240) 575-2526

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 Pratik Shah's NPI number?

The NPI number for Pratik Shah is 1871977793. It was assigned to this individual provider in the NPPES registry on July 10, 2015.

Where is Pratik Shah located?

Pratik Shah practices at 7211 Bank Ct, Frederick, MD 21703. The listed phone number is (240) 566-7830.

What is Pratik Shah's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Pratik Shah enrolled in Medicare?

Yes. Pratik 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.

Which organizations bill Medicare for Pratik Shah's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Pratik Shah reassigns Medicare benefits to 2 organizations: Frederick Health Medical Group LLC (Frederick, MD) and Manalapan Medical Center PA PC (Manalapan, NJ). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Pratik Shah's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Pratik Shah affiliated with any hospitals?

According to CMS data, Pratik Shah is affiliated with Frederick Health Hospital and Jefferson Medical Center.

When was this NPI record last updated?

The NPPES record for Pratik Shah was last updated on August 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.