Active NPI 1659761948 Individual Practitioner Male Practitioner

Dr. Ketankumar Shah , MD

Internal Medicine • Edison, NJ

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Ketankumar Shah, MD is a certified Internal Medicine practicing in Edison, NJ. With approximately 16 years of clinical experience since completing medical education in 2010, Dr. Shah delivers high-quality medical care to the local community at 608 CINDER RD.

Dr. Shah maintains professional affiliations with The William W Backus Hospital, Windham Community Memorial Hospital Inc, Hospitalist Physicians Of New Jersey Pa and accepts Medicare assignment.

Frequently performed procedures and clinical services include subsequent hospital care with moderate levelof medical decision making, if using time, at least, hospital discharge day management, more than, hospital discharge day management. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

608 Cinder Rd

Edison, NJ 088203373

Telephone 7324295499

Medicare Profile & Education

Medical School

Other

Graduation Year

2010

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Edison, NJ

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

16 Yrs -14.3 yrs vs City Avg

City Avg: 30.3 Yrs

State Avg: 30.1 Yrs

Regional Practice Density

80 Specialists

Practicing in Edison, NJ (4957 Statewide)

Telehealth Adoption Rate

27.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

66.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Shah (16 Years) 16 Yrs

Edison Specialty Average (30.3 Years) 30.3 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	452	157	$276.81	$79.43
99239 Hospital discharge day management, more than 30 minutes	60	57	$277.83	$115.72
99238 Hospital discharge day management, 30 minutes or less	58	57	$195.09	$81.36
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	26	26	$457.58	$133.46

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	659	199	$292.32	$83.07
99238 Hospital discharge day management, 30 minutes or less	86	86	$181.34	$85.55
99239 Hospital discharge day management, more than 30 minutes	37	35	$248.24	$121.29
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	34	34	$531.00	$137.33

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	669	301	$291.35	$108.07
99239 Hospital discharge day management, more than 30 minutes	209	197	$273.68	$111.64
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	157	95	$257.03	$75.55
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	65	62	$463.25	$209.77
99217 Hospital observation care on day of discharge	18	17	$161.56	$76.27
99220 Hospital observation care, typically 70 minutes	12	12	$398.00	$189.07

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	387	144	$223.00	$109.95
99239 Hospital discharge day management, more than 30 minutes	114	107	$231.00	$114.07
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	73	31	$156.00	$72.87
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	53	52	$434.00	$213.70
99217 Hospital observation care on day of discharge	20	20	$158.00	$77.45
99220 Hospital observation care, typically 70 minutes	16	16	$398.00	$193.81

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	265	114	$169.83	$78.27
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	99	42	$223.00	$109.18
99239 Hospital discharge day management, more than 30 minutes	61	60	$236.70	$116.79
99238 Hospital discharge day management, 30 minutes or less	32	32	$176.28	$79.19
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	27	27	$315.93	$149.44
99217 Hospital observation care on day of discharge	15	14	$170.67	$78.78

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	369	133	$196.95	$77.56
99238 Hospital discharge day management, 30 minutes or less	79	74	$197.00	$78.27
99225 Subsequent observation care, typically 25 minutes per day	37	24	$195.00	$77.98
99239 Hospital discharge day management, more than 30 minutes	28	28	$289.00	$114.59
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	26	26	$368.00	$146.20
99217 Hospital observation care on day of discharge	23	23	$196.00	$78.29

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	523	199	$217.90	$77.26
99238 Hospital discharge day management, 30 minutes or less	79	76	$200.27	$77.99
99225 Subsequent observation care, typically 25 minutes per day	57	41	$213.25	$78.16
99217 Hospital observation care on day of discharge	48	47	$218.92	$78.71
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	40	39	$418.95	$145.14
99231 Follow-up hospital inpatient care per day, typically 15 minutes	38	28	$136.66	$41.75
99239 Hospital discharge day management, more than 30 minutes	29	29	$291.10	$114.72
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	26	24	$337.69	$112.12
99219 Hospital observation care, typically 50 minutes	11	11	$364.00	$144.23

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	549	200	$194.00	$76.28
99238 Hospital discharge day management, 30 minutes or less	92	88	$197.00	$76.33
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	76	74	$368.00	$145.12
99239 Hospital discharge day management, more than 30 minutes	50	47	$289.00	$114.25
99225 Subsequent observation care, typically 25 minutes per day	38	27	$195.00	$75.71
99217 Hospital observation care on day of discharge	28	27	$196.00	$75.52
99231 Follow-up hospital inpatient care per day, typically 15 minutes	19	19	$105.00	$41.53
99219 Hospital observation care, typically 50 minutes	14	14	$364.00	$135.31

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License CT 054281

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.

Hospital & Practice Group Affiliations

The William W Backus Hospital

326 Washington St, Norwich, CT 063602740

Phone: 8608898331

Hospitalist Physicians Of New Jersey Pa

65 James St, Edison, NJ 088203947

Phone: 7323217000

Windham Community Memorial Hospital Inc

112 Mansfield Ave, Willimantic, CT 062262045

Phone: 8604569116

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active September 01, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location September 01, 2015

Registered at 608 CINDER RD, EDISON, NJ 088203373 (Tel: 7324295499)

📍

Updated Business Mailing Address September 01, 2015

Registered at 608 CINDER RD, EDISON, NJ 088203373 (Tel: 7324295499)

👤

Provider Name / Credentials Updated September 01, 2015

Recorded as KETANKUMAR SHAH, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 01, 2015

Internal Medicine (License #054281 in CT)

🟢

Initial NPI Registration & Enumeration January 26, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1659761948

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: January 26, 2015

Last Update: September 01, 2015

Sole Proprietor: No

Update or Correct Profile

Mailing Address

608 Cinder Rd

Edison, NJ 088203373

Phone: 7324295499

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.