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DR. TORAL SHAH D.O.
NPI 1932587136
Family Medicine - Sleep Medicine in Atlanta, GA

Active since May 08, 2015PECOS EnrolledAccepts Medicare Assignment
92.26/100
CMS Quality Rating
12 EXECUTIVE PARK DR NE, ATLANTA, GA 30329(404) 712-7533 Get Directions Write a Review

NPPES record last updated: January 16, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jul 10, 2019, Mar 15, 2017, Feb 25, 2017 (3 updates tracked since 2017).

About Dr. Toral Shah D.o. NPPES

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

DR. TORAL SHAH D.O. (NPI 1932587136) is an individual sleep medicine provider in Atlanta, Georgia, licensed in Georgia (93383) and active in the NPI registry since May 2015. She is enrolled in Medicare PECOS, is affiliated with Emory University Hospital, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1932587136
Entity TypeIndividualFemale
Primary Taxonomy207QS1201X
Provider Legal NameDR. TORAL SHAHCredential: D.O.
Location Address12 EXECUTIVE PARK DR NEAtlanta, GA 30329-2206
Mailing Address12 Executive Park Dr NeAtlanta, GA 30329-2206 · (404) 712-7533
Phone(404) 712-7533
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateMay 8, 2015
Last NPPES UpdateJanuary 16, 20243 updates tracked since enumeration
NPPES CertifiedJanuary 16, 2024
✔ NPI 1932587136 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sleep MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS1201X
License✔ Licensed in GA · 93383
Definition
A Family Medicine Physician who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders.
12 EXECUTIVE PARK DR NE, Atlanta, GA 30329
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, MedMutual, Oscar Health Insurance.Insurance ›

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

Dr. Toral Shah D.o. 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 ID3375827884
PECOS Enrollment IDI20221104000867
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.

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.
151 services87 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.
50 services50 patients
Sleep study in sleep lab (6 years or older) 95810
A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.
49 services48 patients
Sleep study in sleep lab with continuous airway pressure (6 years or older) 95811
A sleep study in a sleep lab with continuous airway pressure is a test for individuals aged 6 and above. It monitors your sleep patterns to check for disorders like sleep apnea. Continuous airway pressure helps keep your airways open while you sleep, improving your breathing.
44 services41 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.
18 services18 patients

Hospital Affiliations CMS Care Compare

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

Emory University Hospital

Acute Care Hospitals · Atlanta, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110010
Location1364 Clifton Road, NEAtlanta, GA 30322 · De Kalb County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30329 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
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
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.

92.26/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality73.83
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 16

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
9 suppliers150 claims150 services$31.35 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
7 suppliers58 claims58 services$77.18 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
6 suppliers59 claims175 services$28.82 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
6 suppliers44 claims255 services$15.38 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
8 suppliers61 claims357 services$13.08 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
9 suppliers112 claims112 services$47.15 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. PEARL VICTORIA RYDER M.D., PH.D.
Student in an Organized Health Care Education/Training Program
12 EXECUTIVE PARK DR NE, SUITE 331
ATLANTA, GA 30329
Dekalb County (404) 727-5159
CHRISTI N ACKER DPT, PT
Physical Therapist (Neurology)
12 EXECUTIVE PARK DR NE
ATLANTA, GA 30329
Dekalb County (404) 778-7777
ORLA MCQUADE FNP-C
Nurse Practitioner (Family)
12 EXECUTIVE PARK DR NE
ATLANTA, GA 30329
Dekalb County (404) 778-3444
MEGAN LEIGH GOODLIN LCSW
Social Worker (Clinical)
12 EXECUTIVE PARK DR NE
ATLANTA, GA 30329
Dekalb County (850) 591-6066
PETER ASH MD
Psychiatry & Neurology (Psychiatry)
12 EXECUTIVE PARK DR NE, CHILD PSYCHIATRY, SUITE 200
ATLANTA, GA 30329
Dekalb County (404) 727-3973
KELSEY R SPRANG JONES PSYD
Psychologist (Clinical)
12 EXECUTIVE PARK DR NE
ATLANTA, GA 30329
Dekalb County (859) 433-5348
BRANDI ANNE BURKE M.D., M.P.H.
Student in an Organized Health Care Education/Training Program
12 EXECUTIVE PARK DR NE, SUITE 331
ATLANTA, GA 30329
Dekalb County (404) 727-5159
ROCIO CAROLINA GARCIA SANTIBANEZ M.D.
Psychiatry & Neurology (Neuromuscular Medicine)
12 EXECUTIVE PARK DR NE
ATLANTA, GA 30329
Dekalb County (404) 778-3444

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 Toral Shah's NPI number?

The NPI number for Toral Shah is 1932587136. It was assigned to this individual provider in the NPPES registry on May 8, 2015.

Where is Toral Shah located?

Toral Shah practices at 12 Executive Park Dr NE, Atlanta, GA 30329. The listed phone number is (404) 712-7533.

What is Toral Shah's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sleep Medicine, with taxonomy code 207QS1201X.

Is Toral Shah enrolled in Medicare?

Yes. Toral 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.

What insurance does Toral Shah accept?

Health plans from CareSource, MedMutual and Oscar Health Insurance list Toral Shah as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Toral Shah affiliated with any hospitals?

According to CMS data, Toral Shah is affiliated with Emory University Hospital.

When was this NPI record last updated?

The NPPES record for Toral Shah was last updated on January 16, 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.