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DR. SHIBAN K RAINA MD
NPI 1972528610
Internal Medicine - Gastroenterology in Philadelphia, PA

Active since July 13, 2006PECOS EnrolledAccepts Medicare Assignment
700 COTTMAN AVE, SUITE 201, PHILADELPHIA, PA 19111(215) 742-9900(215) 742-7051 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Shiban K Raina Md NPPES

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

DR. SHIBAN K RAINA MD (NPI 1972528610) is an individual gastroenterology provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD057282L) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1969).

NPPES Registry Identity

NPI1972528610
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDR. SHIBAN K RAINACredential: MD
Location Address700 COTTMAN AVE, SUITE 201Philadelphia, PA 19111-3062
Mailing Address700 Cottman Ave, Suite 201Philadelphia, PA 19111-3062 · (215) 742-9900 · Fax (215) 742-7051
Phone(215) 742-9900
Fax(215) 742-7051
Sole ProprietorNo
Medical School CMSOtherGraduated 1969
Enumeration DateJuly 13, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1972528610 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in PA · MD057282L
Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

700 COTTMAN AVE, Philadelphia, PA 19111
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Other Identifiers 3

Medicare ID-Type Unspecified821981
Medicaid001559565/0004PA
Medicare UPING20024

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. Shiban K Raina 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 ID7810098639
PECOS Enrollment IDI20101004000487
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 8

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.
76 services64 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
55 services54 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.
46 services37 patients
Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
35 services35 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
28 services28 patients
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121
Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.
22 services22 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19111 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
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
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.

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…
92%356 patients4/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
100%121 patients5/55-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%1,235 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.
81%440 patients4/55-star benchmark: 100%
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.
98%40 patients4/55-star benchmark: 100%
Photodocumentation of Cecal Intubation
The rate of screening and surveillance colonoscopies for which photodocumentation of landmarks of cecal intubation is performed to establish a complete examination
98%53 patients
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…
84%955 patients4/55-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
97%245 patients4/55-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…
77%317 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…
2%317 patients1/55-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.

Other Providers at the Same Location NPPES 19

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

JULIE HOLESH P.A.
Physician Assistant
700 COTTMAN AVE, SUITE 201
PHILADELPHIA, PA 19111
Philadelphia County (215) 742-9900
MR. FRANK GABRIEL COSENTINO CRNA
Nurse Anesthetist, Certified Registered
700 COTTMAN AVE
PHILADELPHIA, PA 19111
Philadelphia County (215) 742-9400
GILBERT GROSSMAN MD
Internal Medicine (Cardiovascular Disease)
700 COTTMAN AVE, BLDG B, SUITE 101
PHILADELPHIA, PA 19111
Philadelphia County (215) 745-4100
MISTY SUE HARTH MHS, PA-C
Physician Assistant (Medical)
700 COTTMAN AVE, SUITE 201
PHILADELPHIA, PA 19111
Philadelphia County (215) 742-9900
MS. SARAH MARIE COMBS PHYSICIAN ASSISTANT
Physician Assistant (Medical)
700 COTTMAN AVE
PHILADELPHIA, PA 19111
Philadelphia County (215) 742-9900
DR. DANIEL J. SHER M.D.
Internal Medicine (Gastroenterology)
700 COTTMAN AVE, SUITE 201
PHILADELPHIA, PA 19111
Philadelphia County (215) 742-9900
ABRAHAM JOHN
Nurse Practitioner (Family)
700 COTTMAN AVE
PHILADELPHIA, PA 19111
Philadelphia County (215) 662-7366
NINA NGO PA-C
Physician Assistant (Medical)
700 COTTMAN AVE
PHILADELPHIA, PA 19111
Philadelphia County (215) 742-9900

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 Shiban Raina's NPI number?

The NPI number for Shiban Raina is 1972528610. It was assigned to this individual provider in the NPPES registry on July 13, 2006.

Where is Shiban Raina located?

Shiban Raina practices at 700 Cottman Ave Suite 201, Philadelphia, PA 19111. The listed phone number is (215) 742-9900.

What is Shiban Raina's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Shiban Raina enrolled in Medicare?

Yes. Shiban Raina 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.

When was this NPI record last updated?

The NPPES record for Shiban Raina was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.