Active NPI 1023106473 Individual Practitioner Female Practitioner

Dr. Sheila Mary Rice , MD

Internal Medicine • Avon, OH

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Sheila Rice, MD is a certified Internal Medicine practicing in Avon, OH. With approximately 29 years of clinical experience since graduating from University Of Toledo College Of Medicine in 1997, Dr. Rice delivers high-quality medical care to the local community at 36711 AMERICAN WAY STE A.

Dr. Rice is affiliated with University Primary Care Practices Inc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, advance care planning, first, annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

36711 American Way Ste A

Avon, OH 440114062

Telephone 4406538091

Fax 4406538089

Associated Practice Facility / Clinic

🏢 Northeast Ohio Surgery Center, Llc Facility NPI 1891793915

Medicare Profile & Education

Medical School

University Of Toledo College Of Medicine

Graduation Year

1997

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Avon, OH

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

29 Yrs -0.1 yrs vs City Avg

City Avg: 29.1 Yrs

State Avg: 26.9 Yrs

Regional Practice Density

16 Specialists

Practicing in Avon, OH (5516 Statewide)

Telehealth Adoption Rate

56.2% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

60.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Rice (29 Years) 29 Yrs

Avon Specialty Average (29.1 Years) 29.1 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
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	290	240	$187.00	$58.54
99497 Advance care planning, first 30 minutes	236	236	$165.00	$6.48
G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes	231	231	$50.00	$24.30
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	227	227	$235.00	$39.65
G0444 Annual depression screening, 5 to 15 minutes	212	212	$35.00	$17.72
G0101 Cervical or vaginal cancer screening; pelvic and clinical breast examination	108	108	$60.00	$37.12
G0442 Annual alcohol misuse screening, 5 to 15 minutes	103	103	$35.00	$17.78
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	60	47	$38.00	$15.87
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	55	50	$262.00	$111.87
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	49	24	$52.00	$13.50
G0447 Face-to-face behavioral counseling for obesity, 15 minutes	41	38	$45.00	$24.34
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	39	39	$665.00	$285.25
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	38	17	$8.45	$1.25
G0009 Administration of pneumococcal vaccine	37	37	$44.00	$30.59
90662 Influenza vaccine split virus, preservative free	30	30	$67.00	$65.66
G0008 Administration of influenza virus vaccine	30	30	$44.00	$30.42
G0136 Administration of a standardized, evidence-based social determinants of health risk assessment tool, 5-15 minutes	22	22	$45.00	$17.79
93000 Routine ekg using at least 12 leads including interpretation and report	16	15	$72.00	$13.51
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	13	13	$300.00	$148.73

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	242	205	$175.00	$64.00
G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes	242	242	$50.00	$25.24
99497 Advance care planning, first 30 minutes	230	230	$165.00	$7.68
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	222	222	$203.08	$36.54
G0444 Annual depression screening, 5 to 15 minutes	218	218	$35.00	$17.52
99490 Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month	136	31	$75.00	$60.34
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	102	74	$245.00	$89.35
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	68	68	$665.00	$282.11
G0009 Administration of pneumococcal vaccine	66	66	$44.00	$29.36
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	35	21	$52.00	$13.51
G0008 Administration of influenza virus vaccine	33	33	$44.18	$29.36
90662 Influenza vaccine split virus, preservative free	27	27	$67.00	$65.66
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	25	15	$11.65	$1.76
G0447 Face-to-face behavioral counseling for obesity, 15 minutes	25	25	$45.00	$24.94
99439 Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month	24	13	$85.00	$45.43
99213 Established patient office or other outpatient visit, typically 15 minutes	16	15	$125.00	$61.19
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	15	15	$240.00	$150.90
99443 Telephone medical discussion with physician, 21-30 minutes	12	11	$158.00	$122.49

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	316	227	$164.97	$62.46
G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes	235	235	$50.00	$26.04
99497 Advance care planning, first 30 minutes	221	221	$165.00	$10.84
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	215	215	$203.00	$41.72
G0444 Annual depression screening, 5 to 15 minutes	212	212	$35.00	$17.74
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	110	82	$220.80	$105.77
G0101 Cervical or vaginal cancer screening; pelvic and clinical breast examination	100	100	$60.00	$38.61
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	76	28	$51.96	$13.90
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	58	17	$11.00	$1.74
G0008 Administration of influenza virus vaccine	42	42	$44.00	$27.98
G0009 Administration of pneumococcal vaccine	40	40	$44.00	$28.18
90662 Influenza vaccine split virus, preservative free	37	37	$67.00	$65.65
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	31	31	$665.00	$276.72
99443 Telephone medical discussion with physician, 21-30 minutes	22	19	$158.00	$125.79
93000 Routine ekg using at least 12 leads including interpretation and report	19	18	$72.00	$13.94
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	16	16	$240.00	$164.68
99213 Established patient office or other outpatient visit, typically 15 minutes	16	15	$120.00	$59.45
99442 Telephone medical discussion with physician, 11-20 minutes	14	13	$100.00	$88.57
99406 Smoking and tobacco use intermediate counseling, greater than 3 minutes up to 10 minutes	14	13	$25.00	$15.14

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	1,381	18	$30.00	$20.58
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	310	215	$157.00	$126.50
G0446 Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes	228	228	$50.00	$26.15
99497 Advance care planning, first 30 minutes	222	219	$165.00	$83.55
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	218	218	$203.00	$128.66
G0444 Annual depression screening, 5 to 15 minutes	216	216	$35.00	$17.81
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	128	95	$210.00	$174.98
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	62	32	$49.00	$13.10
G0009 Administration of pneumococcal vaccine	33	33	$44.00	$16.18
G0008 Administration of influenza virus vaccine	32	32	$44.00	$16.19
93000 Routine ekg using at least 12 leads including interpretation and report	28	28	$72.00	$14.34
90662 Influenza vaccine split virus, preservative free	27	27	$67.00	$65.26
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m servic	27	21	$36.00	$14.27
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	26	13	$11.00	$1.63
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	23	23	$207.17	$125.40
99213 Established patient office or other outpatient visit, typically 15 minutes	23	22	$106.00	$86.00
G0180 Physician or allowed practitioner 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 and	20	17	$118.00	$51.09
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	19	19	$240.00	$162.73
99442 Telephone medical discussion with physician, 11-20 minutes	16	13	$100.00	$89.38
99443 Telephone medical discussion with physician, 21-30 minutes	16	12	$158.00	$126.88

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	2,101	22	$30.00	$19.63
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	384	218	$151.93	$105.93
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	210	210	$203.00	$112.92
G0101 Cervical or vaginal cancer screening; pelvic and clinical breast examination	108	108	$60.00	$39.53
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	88	62	$203.86	$141.35
G0009 Administration of pneumococcal vaccine	82	82	$44.00	$15.76
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	73	41	$49.00	$13.89
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	72	72	$152.00	$115.70
99213 Established patient office or other outpatient visit, typically 15 minutes	53	49	$103.00	$72.99
G0008 Administration of influenza virus vaccine	39	39	$44.00	$16.07
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	36	21	$11.00	$2.00
90662 Influenza vaccine split virus, preservative free	34	34	$67.00	$60.98
93000 Routine ekg using at least 12 leads including interpretation and report	24	24	$72.00	$16.57
90472 Administration of vaccine, each additional vaccine	23	23	$19.00	$12.48
99442 Telephone medical discussion with physician, 11-20 minutes	19	19	$46.32	$43.98
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	18	18	$240.89	$162.92
G0180 Physician or allowed practitioner 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 and	16	11	$118.00	$52.19
99443 Telephone medical discussion with physician, 21-30 minutes	13	12	$82.62	$71.58
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	11	11	$65.00	$44.11

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	1,921	26	$30.00	$18.75
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	421	214	$150.00	$105.39
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	162	162	$203.00	$112.96
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	79	62	$200.00	$142.06
G0009 Administration of pneumococcal vaccine	60	59	$44.00	$15.75
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	52	39	$49.00	$16.05
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	41	41	$152.00	$110.38
G0008 Administration of influenza virus vaccine	32	32	$44.00	$15.75
99213 Established patient office or other outpatient visit, typically 15 minutes	30	28	$100.00	$72.11
90662 Influenza vaccine split virus, preservative free	24	24	$67.00	$54.78
93000 Routine ekg using at least 12 leads including interpretation and report	22	21	$72.00	$16.40
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	19	13	$11.00	$1.81
90670 Pneumococcal vaccine for injection into muscle	19	19	$319.00	$207.86
99496 Transitional care management services for problem of high complexity	15	13	$426.00	$224.86
G0180 Physician or allowed practitioner 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 and	13	11	$118.00	$51.65
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$235.00	$160.76

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	2,056	28	$28.98	$17.87
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	407	227	$205.58	$103.32
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	137	137	$245.39	$111.78
99213 Established patient office or other outpatient visit, typically 15 minutes	113	91	$149.35	$70.20
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	67	42	$51.97	$19.39
93000 Routine ekg using at least 12 leads including interpretation and report	36	34	$46.75	$16.20
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	36	31	$285.33	$139.89
G0008 Administration of influenza virus vaccine	27	27	$45.11	$19.30
90662 Influenza vaccine split virus, preservative free	23	23	$65.30	$51.75
G0009 Administration of pneumococcal vaccine	21	21	$43.57	$19.30
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	21	21	$162.67	$105.59
G0180 Physician or allowed practitioner 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 and	20	17	$122.90	$51.56
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	19	11	$13.53	$1.99
90471 Administration of 1 vaccine	17	14	$53.18	$16.05
81002 Urinalysis, manual test	13	11	$12.69	$3.41
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$234.18	$104.52

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	1,020	17	$26.67	$16.86
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	521	246	$243.82	$100.57
99213 Established patient office or other outpatient visit, typically 15 minutes	136	105	$170.49	$67.67
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	113	113	$272.83	$110.51
90471 Administration of 1 vaccine	51	46	$54.69	$23.89
G0008 Administration of influenza virus vaccine	51	51	$59.00	$23.76
G0403 Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report	48	48	$39.29	$16.12
90662 Influenza vaccine split virus, preservative free	46	46	$54.00	$48.05
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	45	45	$354.07	$157.98
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	44	25	$58.25	$23.87
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	35	35	$400.20	$163.71
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	34	34	$180.00	$96.61
G0009 Administration of pneumococcal vaccine	30	30	$43.43	$23.76
93000 Routine ekg using at least 12 leads including interpretation and report	22	22	$37.77	$16.12
90670 Pneumococcal vaccine for injection into muscle	15	15	$300.00	$188.79
90674 Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free	12	12	$37.00	$23.57
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	11	11	$350.73	$136.19
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$239.55	$103.64

Medical Specialties & State Licenses

CMS Verified: 2020-11-10

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License OH 35076192

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

0492328 (OH)

Medicaid State Provider ID

2177399 (OH)

Commercial Insurance / Payer ID Aetna

7471142 (OH)

Commercial Insurance / Payer ID Anthem

000001076245 (OH)

Commercial Insurance / Payer ID Medicare

H485680 (OH)

Commercial Insurance / Payer ID Railroad Medicare

P01827145 (OH)

Hospital & Practice Group Affiliations

University Primary Care Practices Inc

158 W Main Rd, Conneaut, OH 440302039

Phone: 4402852960

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners

Donna Goodwin , APRN, CNP

Nurse Practitioner - Family

NPI 1295255610

Advanced Practice Registered Nurse, Certified Nurse Practitioner

Dr. Jennifer Carandang , MD

Internal Medicine

NPI 1912909862

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

13 Historical Events

✅

NPI Profile Active October 19, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location October 19, 2017

Registered at 36711 AMERICAN WAY STE A, AVON, OH 440114062 (Tel: 4406538091)

📍

Updated Business Mailing Address October 19, 2017

Registered at 3755 ORANGE PLACE, SUITE #101, ORANGE VILLAGE, OH 441224455 (Tel: 4406538091)

👤

Provider Name / Credentials Updated October 19, 2017

Recorded as SHEILA RICE, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 19, 2017

Internal Medicine (License #35076192 in OH)

📍

Updated Practice Location May 31, 2017

Registered at 36711 AMERICAN WAY STE A, AVON, OH 440114062 (Tel: 4406538091)

📍

Updated Business Mailing Address May 31, 2017

Registered at 3755 ORANGE PLACE, SUITE #101, ORANGE VILLAGE, OH 441224455 (Tel: 4406538091)

✅

NPI Profile Active September 24, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location September 24, 2015

Registered at 33100 CLEVELAND CLINIC BLVD, AVON, OH 44011 (Tel: 4406954000)

📍

Updated Business Mailing Address September 24, 2015

Registered at 33100 CLEVELAND CLINIC BLVD, AVON, OH 44011 (Tel: 4406954000)

👤

Provider Name / Credentials Updated September 24, 2015

Recorded as SHEILA RICE, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 24, 2015

Internal Medicine (License #35076192 in OH)

🟢

Initial NPI Registration & Enumeration October 11, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1023106473

Entity Type:

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

Enumeration Date: October 11, 2006

Last Update: November 10, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

3755 Orange Place, Suite #101

Orange Village, OH 441224455

Phone: 4406538091

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.