NIRAV SHAH MD
NPI 1922495696
Family Medicine in Utica, NY

Q: What is Nirav Shah's NPI number?

The NPI number for Nirav Shah is 1922495696. It was assigned to this individual provider in the NPPES registry on April 21, 2015.

Q: What is Nirav Shah's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Nirav Shah was last updated on September 28, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 21, 2015PECOS EnrolledAccepts Medicare Assignment

78.7/100

CMS Quality Rating

1656 CHAMPLIN AVE, UTICA, NY 13502(315) 624-6829(315) 624-6469 Get Directions Write a Review

NPPES record last updated: September 28, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Nirav Shah Md NPPES

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

NIRAV SHAH MD (NPI 1922495696) is an individual family medicine provider in Utica, New York, licensed in New York (295784) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS, is affiliated with Wynn Hospital, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1922495696

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameNIRAV SHAHCredential: MD

Location Address1656 CHAMPLIN AVEUtica, NY 13502-4830

Mailing Address2209 Genesee St., Business OfficeUtica, NY 13501-5930 · (315) 801-4238 · Fax (315) 801-8391

Phone(315) 624-6829

Fax(315) 624-6469

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateApril 21, 2015

Last NPPES UpdateSeptember 28, 2018

✔ NPI 1922495696 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NY · 295784

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1656 CHAMPLIN AVE, Utica, NY 13502

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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

Nirav Shah Md 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 ID6901158153

PECOS Enrollment IDI20181016002969

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 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 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.

377 services150 patients

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.

296 services107 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.

87 services87 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

60 services60 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.

26 services26 patients

Hospital Affiliations CMS Care Compare 2

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

Wynn Hospital

Acute Care Hospitals · Utica, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330044

Location111 Hospital DriveUtica, NY 13502 · Oneida County

Emergency services Birthing friendly

St Luke's Cornwall Hospital

Acute Care Hospitals · Newburgh, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number330264

Location70 Dubois StreetNewburgh, NY 12550 · Orange County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13502 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

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

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.

78.7/100

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

Scored as part of a group practice

Quality

81.73

Promoting Interoperability

Improvement Activities

Cost

42.38

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. JOHN F SPERLING M.D.

Surgery

1656 CHAMPLIN AVE, P.O.B., SUITE 335
UTICA, NY 13502

Oneida County (315) 624-4090

MR. TRACY S HEATON R.PH,

Pharmacist