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DR. NIMISHA H SHAH M.D.
NPI 1932187945
Internal Medicine in Morgan Hill, CA

Active since January 09, 2006PECOS EnrolledAccepts Medicare Assignment
18550 DE PAUL DR, SUITE # 101 DE PAUL HEALTH CENTER, MORGAN HILL, CA 95037(408) 776-3900(408) 776-3919 Get Directions Write a Review

NPPES record last updated: February 21, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Nimisha H Shah M.d. NPPES

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

DR. NIMISHA H SHAH M.D. (NPI 1932187945) is an individual internal medicine provider in Morgan Hill, California, licensed in California (A84372) and active in the NPI registry since January 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1988).

NPPES Registry Identity

NPI1932187945
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. NIMISHA H SHAHCredential: M.D.
Location Address18550 DE PAUL DR, SUITE # 101 DE PAUL HEALTH CENTERMorgan Hill, CA 95037-2911
Mailing Address18550 De Paul Dr, Suite # 101 De Paul Health CenterMorgan Hill, CA 95037-2911 · (408) 776-3900 · Fax (408) 776-3919
Phone(408) 776-3900
Fax(408) 776-3919
Sole ProprietorYes
Medical School CMSOtherGraduated 1988
Enumeration DateJanuary 9, 2006
Last NPPES UpdateFebruary 21, 2024
NPPES CertifiedFebruary 21, 2024
✔ NPI 1932187945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · A84372
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
18550 DE PAUL DR, Morgan Hill, CA 95037
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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

Dr. Nimisha H 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 ID6608859012
PECOS Enrollment IDI20040608000766
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 Nimisha Shah reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

County Of Santa Clara
Same address
Clinic/Center
18550 DE PAUL DR
Morgan Hill, CA 95037
  • Reassigned Medicare billing, California enrollment
  • 2,460 clinicians in this Medicare group
NPI 1114676251 (408) 885-5000
Verity Medical Foundation
18 mi
Multi-Specialty
625 LINCOLN AVE
San Jose, CA 95126
  • Reassigned Medicare billing, California enrollment
  • 133 clinicians in this Medicare group
NPI 1326312067 (405) 278-3000

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 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.

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.
363 services189 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.
340 services219 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
246 services246 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
217 services130 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
79 services73 patients
Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a G0179
This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.
36 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95037 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
$156.67 typical visit price
range $70.37 – $206.04
Typical copayment $39.16 (range $17.59 – $51.51)
Most-billed visit code 99204
Established Patient
$121.77 typical visit price
range $23.96 – $169.60
Typical copayment $30.44 (range $5.99 – $42.40)
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.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
3%527 patients1/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%4,420 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
58%1,728 patients3/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
15%139 patients1/55-star benchmark: 98%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%205 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
5%719 patients1/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
38%1,583 patients2/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
17%29 patients1/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
17%1,183 patients1/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
88%719 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
39%719 patients2/55-star benchmark: 79%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
8 suppliers21 claims67 services$5.20 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
5 suppliers16 claims25 services$0.75 avg. paid by Medicare
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty E0181
DME-Other DME · category DE000N
1 supplier12 claims12 services$9.69 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
1 supplier12 claims12 services$57.17 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 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FRITTER, SCHULZ & CONLAN PHYSICAL & OCCUPATIONAL THERAPY
Physical Therapist
18550 DE PAUL DR, SUITE 100
MORGAN HILL, CA 95037
Santa Clara County (408) 779-4343
COUNTY OF SANTA CLARA
Clinic/Center
18550 DE PAUL DR
MORGAN HILL, CA 95037
Santa Clara County (408) 885-5000
DR. WILLIAM BRIAN JOYCE MD
Internal Medicine
18550 DE PAUL DR, SUITE 208
MORGAN HILL, CA 95037
Santa Clara County (408) 776-8040
COUNTY OF SANTA CLARA
Clinic/Center (Federally Qualified Health Center (FQHC))
18550 DE PAUL DR
MORGAN HILL, CA 95037
Santa Clara County (408) 885-5000
COUNTY OF SANTA CLARA
Clinic/Center (Federally Qualified Health Center (FQHC))
18550 DE PAUL DR, 103,104,109,202,205,207,203,206,208,120,130,140,150
MORGAN HILL, CA 95037
Santa Clara County (408) 885-5000
COUNTY OF SANTA CLARA
Clinic/Center (Federally Qualified Health Center (FQHC))
18550 DE PAUL DR
MORGAN HILL, CA 95037
Santa Clara County (408) 885-5000
DR. VISOTH CHHIAP M.D.
Dermatology
18550 DE PAUL DR, SUITE 204
MORGAN HILL, CA 95037
Santa Clara County (408) 779-1772
MRS. WINONA DARLENE WEIDEMANN R.N. F.N.P.
Nurse Practitioner (Family)
18550 DE PAUL DR, STE 208
MORGAN HILL, CA 95037
Santa Clara County (408) 776-8040

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 Nimisha Shah's NPI number?

The NPI number for Nimisha Shah is 1932187945. It was assigned to this individual provider in the NPPES registry on January 9, 2006.

Where is Nimisha Shah located?

Nimisha Shah practices at 18550 De Paul Dr Suite # 101 De Paul Health Center, Morgan Hill, CA 95037. The listed phone number is (408) 776-3900.

What is Nimisha Shah's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Nimisha Shah enrolled in Medicare?

Yes. Nimisha 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 Nimisha Shah's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nimisha Shah reassigns Medicare benefits to 2 organizations: County Of Santa Clara (Morgan Hill, CA) and Verity Medical Foundation (San Jose, CA). 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 Nimisha Shah's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nimisha Shah was last updated on February 21, 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.