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: July 27, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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 Maryland (D89673) 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
Sole ProprietorYes
Medical School CMSOtherGraduated 2015
Enumeration DateJuly 10, 2015
Last NPPES UpdateJuly 27, 2020
NPPES CertifiedJuly 27, 2020
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
License 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.

7211 BANK CT, Frederick, MD 21703

Secondary Practice Location 1

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

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

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.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 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, 30-39 minutes 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.
419 services274 patients
Established patient office or other outpatient visit, 40-54 minutes 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.
113 services77 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.
94 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.
29 services28 patients
New patient office or other outpatient visit, 45-59 minutes 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.
22 services22 patients
New patient office or other outpatient visit, 60-74 minutes 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.
14 services14 patients

Hospital Affiliations CMS Care Compare

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

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.

Specialist
7211 BANK CT, SUITE 200
FREDERICK, MD 21703
Physician Assistant (Medical)
7211 BANK CT
FREDERICK, MD 21703
Family Medicine
7211 BANK CT
FREDERICK, MD 21703
Family Medicine
7211 BANK CT
FREDERICK, MD 21703
Internal Medicine (Endocrinology, Diabetes & Metabolism)
7211 BANK CT, SUITE 240
FREDERICK, MD 21703
Dietitian, Registered (Nutrition, Metabolic)
7211 BANK CT
FREDERICK, MD 21703
Dietitian, Registered
7211 BANK CT, SUITE 240
FREDERICK, MD 21703
Physician Assistant (Medical)
7211 BANK CT
FREDERICK, MD 21703

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1871977793, enumerated as an "individual" on July 10, 2015.

The provider is located at 7211 BANK CT FREDERICK, MD 21703 and the phone number is (240) 566-7830.

Internal Medicine with taxonomy code 207RE0101X and a focus in Endocrinology, Diabetes & Metabolism.

Pratik Shah is affiliated with: FREDERICK HEALTH HOSPITAL.