1. Home
  2. Directory
  3. Massachusetts
  4. Burlington
  5. Nurse Practitioner
  6. NPI Profile

PRACHI SHAH
NPI 1952076200
Nurse Practitioner in Burlington, MA

Active since August 10, 2021PECOS EnrolledAccepts Medicare Assignment
91.41/100
CMS Quality Rating
67 S BEDFORD ST STE 101, BURLINGTON, MA 01803(781) 744-8000 Get Directions Write a Review

NPPES record last updated: August 31, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Prachi Shah NPPES

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

PRACHI SHAH (NPI 1952076200) is an individual nurse practitioner in Burlington, Massachusetts, licensed in Massachusetts (RN2308375) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS, is affiliated with Northeast Hospital Corporation, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1952076200
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NamePRACHI SHAH
Location Address67 S BEDFORD ST STE 101Burlington, MA 01803-5108
Mailing Address67 S Bedford St Ste 202eBurlington, MA 01803-5141 · (781) 744-8000
Phone(781) 744-8000
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateAugust 10, 2021
Last NPPES UpdateAugust 31, 2021
NPPES CertifiedAugust 31, 2021
✔ NPI 1952076200 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in MA · RN2308375
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedRegistered NurseTaxonomy 163W00000X · License RN2308375 (MA)
67 S BEDFORD ST STE 101, Burlington, MA 01803
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

Prachi Shah 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 ID5193121655
PECOS Enrollment IDI20210908002438
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 3

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 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.
275 services170 patients
Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212
This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.
136 services70 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.
99 services76 patients

Hospital Affiliations CMS Care Compare 4

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

Northeast Hospital Corporation

Acute Care Hospitals · Beverly, MA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220033
Location85 Herrick StreetBeverly, MA 01915 · Essex County
Emergency services Birthing friendly

Beth Israel Deaconess Medical Center

Acute Care Hospitals · Boston, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220086
Location330 Brookline AvenueBoston, MA 02215 · Suffolk County
Emergency services Birthing friendly

Winchester Hospital

Acute Care Hospitals · Winchester, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220105
Location41 Highland AvenueWinchester, MA 01890 · Middlesex County
Emergency services Birthing friendly

Lahey Hospital & Medical Center, Burlington

Acute Care Hospitals · Burlington, MA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220171
Location41 & 45 Mall RoadBurlington, MA 01803 · Middlesex County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01803 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
$97.64 typical visit price
range $63.72 – $189.86
Typical copayment $24.41 (range $15.93 – $47.46)
Most-billed visit code 99203
Established Patient
$111.18 typical visit price
range $21.07 – $155.29
Typical copayment $27.79 (range $5.26 – $38.82)
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.

91.41/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality76.87
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims

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

Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
1 supplier15 claims15 services$27.43 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 2

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

ANNE Y NING MD
Dermatology
67 S BEDFORD ST STE 101
BURLINGTON, MA 01803
Middlesex County (781) 744-8000
CLARA GARCIA
Behavior Technician
67 S BEDFORD ST STE 101
BURLINGTON, MA 01803
Middlesex County (619) 410-7967

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 Prachi Shah's NPI number?

The NPI number for Prachi Shah is 1952076200. It was assigned to this individual provider in the NPPES registry on August 10, 2021.

Where is Prachi Shah located?

Prachi Shah practices at 67 S Bedford St Ste 101, Burlington, MA 01803. The listed phone number is (781) 744-8000.

What is Prachi Shah's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Prachi Shah enrolled in Medicare?

Yes. Prachi 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 Prachi Shah accept?

Health plans from Anthem Blue Cross and Blue Shield list Prachi 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 Prachi Shah affiliated with any hospitals?

According to CMS data, Prachi Shah is affiliated with Northeast Hospital Corporation, Beth Israel Deaconess Medical Center, Winchester Hospital and Lahey Hospital & Medical Center, Burlington.

When was this NPI record last updated?

The NPPES record for Prachi Shah was last updated on August 31, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.