Active NPI 1285616383 Individual Practitioner Male Practitioner

Dr. Sanjay Y Sheth , MD

Internal Medicine • Niles, OH

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Sanjay Sheth, MD is a certified Internal Medicine practicing in Niles, OH. With approximately 24 years of clinical experience since completing medical education in 2002, Dr. Sheth delivers high-quality medical care to the local community at 940 ROBBINS AVE.

Dr. Sheth is affiliated with S And J Med Inc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, subsequent hospital care with moderate levelof medical decision making, if using time, at least, 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

940 Robbins Ave

Niles, OH 444462468

Telephone 3306527973

Fax 3306527876

Associated Practice Facility / Clinic

🏢 Dr. Yogesh O. Sheth, Md Facility NPI 1205816501

Medicare Profile & Education

Medical School

Other

Graduation Year

2002

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Niles, OH

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

24 Yrs -11.3 yrs vs City Avg

City Avg: 35.3 Yrs

State Avg: 26.9 Yrs

Regional Practice Density

9 Specialists

Practicing in Niles, OH (5516 Statewide)

Telehealth Adoption Rate

11.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

20.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Sheth (24 Years) 24 Yrs

Niles Specialty Average (35.3 Years) 35.3 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
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	317	136	$130.00	$121.53
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	236	55	$85.00	$75.03
99213 Established patient office or other outpatient visit, typically 15 minutes	143	94	$95.00	$86.06
99238 Hospital discharge day management, 30 minutes or less	97	69	$80.00	$76.89
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	91	64	$205.00	$161.00
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	90	90	$145.00	$122.81
G0008 Administration of influenza virus vaccine	49	47	$25.00	$24.50
90661 Influenza vaccine, trivalent derived from cell cultures	46	46	$75.00	$36.11
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	38	17	$125.00	$113.33
82962 Blood glucose (sugar) test performed by hand-held instrument	28	15	$16.00	$3.21
G0009 Administration of pneumococcal vaccine	27	27	$30.00	$29.40
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	24	24	$350.00	$287.49
G0444 Annual depression screening, 5 to 15 minutes	23	23	$35.00	$17.57
87635 Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen	21	20	$75.00	$50.28
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	17	14	$110.00	$50.38
99496 Transitional care management services for problem of high complexity	16	15	$300.00	$263.34
94060 Test to measure expiratory airflow and volume changes before and after medication administration	14	14	$75.00	$35.84
99495 Transitional care management services for problem of at least moderate complexity	11	11	$250.00	$195.22

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	371	149	$130.00	$123.82
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	241	62	$85.00	$77.85
99213 Established patient office or other outpatient visit, typically 15 minutes	158	104	$95.00	$87.37
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	104	104	$145.00	$125.39
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	93	67	$205.00	$167.46
99238 Hospital discharge day management, 30 minutes or less	81	63	$79.51	$78.70
G0009 Administration of pneumococcal vaccine	54	54	$30.00	$29.36
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	46	46	$350.00	$282.68
G0008 Administration of influenza virus vaccine	41	41	$25.00	$24.50
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	38	38	$40.00	$20.46
G0444 Annual depression screening, 5 to 15 minutes	35	35	$35.00	$17.64
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	34	12	$121.47	$116.24
99496 Transitional care management services for problem of high complexity	22	20	$300.00	$266.94
93000 Routine ekg using at least 12 leads including interpretation and report	18	17	$95.00	$13.93
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	17	13	$110.00	$50.23
82962 Blood glucose (sugar) test performed by hand-held instrument	15	11	$16.00	$3.21
99495 Transitional care management services for problem of at least moderate complexity	11	11	$250.00	$196.96

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	420	161	$95.00	$87.78
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	341	69	$85.00	$69.29
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	108	108	$145.00	$125.64
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	107	76	$130.00	$123.75
99238 Hospital discharge day management, 30 minutes or less	91	69	$75.00	$69.43
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	83	61	$205.00	$190.36
90756 Vaccine for influenza for injection into muscle	56	56	$40.00	$29.97
G0008 Administration of influenza virus vaccine	52	52	$25.00	$24.50
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	46	19	$110.00	$99.63
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	26	23	$110.00	$50.94
87635 Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen	22	20	$75.00	$50.73
G0009 Administration of pneumococcal vaccine	21	21	$30.00	$28.11
99495 Transitional care management services for problem of at least moderate complexity	21	21	$250.00	$198.95
82962 Blood glucose (sugar) test performed by hand-held instrument	21	12	$16.00	$3.24
81002 Urinalysis, manual test	19	16	$25.00	$3.44
99496 Transitional care management services for problem of high complexity	17	16	$300.00	$267.94
99220 Hospital observation care, typically 70 minutes	14	14	$185.00	$174.32
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	12	$70.00	$54.28
99217 Hospital observation care on day of discharge	13	13	$110.00	$69.26
93000 Routine ekg using at least 12 leads including interpretation and report	11	11	$95.00	$13.80
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	11	11	$195.00	$161.03

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	426	181	$94.41	$88.77
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	262	65	$85.00	$70.48
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	106	106	$141.60	$128.52
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	104	42	$110.00	$101.25
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	104	74	$128.99	$125.73
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	69	56	$205.00	$192.26
G0008 Administration of influenza virus vaccine	53	53	$25.00	$16.19
90756 Vaccine for influenza for injection into muscle	53	53	$39.15	$28.37
99239 Hospital discharge day management, more than 30 minutes	52	38	$135.00	$103.75
85610 Blood test, clotting time	41	13	$30.00	$4.29
99238 Hospital discharge day management, 30 minutes or less	30	28	$75.00	$70.40
99291 Critical care, first 30-74 minutes	23	20	$260.00	$217.91
99495 Transitional care management services for problem of at least moderate complexity	19	19	$250.00	$199.38
G0009 Administration of pneumococcal vaccine	18	18	$30.00	$16.18
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	14	$110.00	$51.09
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	16	16	$69.69	$54.37
82962 Blood glucose (sugar) test performed by hand-held instrument	14	11	$16.00	$3.28
J1020 Injection, methylprednisolone acetate, 20 mg	14	11	$27.00	$3.18
81002 Urinalysis, manual test	14	11	$25.00	$3.48
99496 Transitional care management services for problem of high complexity	13	13	$300.00	$270.05
99220 Hospital observation care, typically 70 minutes	12	12	$185.00	$178.36

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	577	213	$85.00	$71.65
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	216	69	$85.00	$71.64
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	173	62	$110.00	$103.28
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	119	119	$131.72	$111.81
99239 Hospital discharge day management, more than 30 minutes	104	69	$135.00	$105.50
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	75	51	$205.00	$198.66
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	72	57	$115.00	$105.02
85610 Blood test, clotting time	69	14	$30.00	$4.26
G0008 Administration of influenza virus vaccine	60	60	$25.00	$16.07
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	60	60	$35.00	$19.15
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	34	30	$65.00	$42.33
G0009 Administration of pneumococcal vaccine	33	33	$30.00	$15.99
82962 Blood glucose (sugar) test performed by hand-held instrument	32	25	$16.00	$3.26
99495 Transitional care management services for problem of at least moderate complexity	31	28	$250.00	$178.65
99220 Hospital observation care, typically 70 minutes	30	25	$185.00	$183.66
J1020 Injection, methylprednisolone acetate, 20 mg	24	15	$27.00	$3.56
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	21	15	$110.00	$51.59
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	19	19	$185.00	$165.56
81002 Urinalysis, manual test	17	14	$25.00	$3.46
90670 Pneumococcal vaccine for injection into muscle	17	17	$254.71	$225.21
99291 Critical care, first 30-74 minutes	17	13	$260.00	$221.65
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	16	14	$150.00	$137.25
99217 Hospital observation care on day of discharge	16	14	$110.00	$71.99
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	16	16	$125.00	$118.42
36415 Insertion of needle into vein for collection of blood sample	15	15	$15.00	$3.00
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	14	14	$39.29	$13.01

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	671	229	$85.00	$71.06
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	331	106	$85.00	$71.08
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	173	73	$110.00	$101.64
99239 Hospital discharge day management, more than 30 minutes	150	110	$135.00	$104.21
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	117	117	$131.32	$110.97
85610 Blood test, clotting time	111	21	$30.00	$4.28
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	107	88	$205.00	$197.67
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	79	12	$55.00	$21.41
90756 Vaccine for influenza for injection into muscle	52	52	$35.00	$26.13
G0008 Administration of influenza virus vaccine	52	52	$25.00	$15.75
99495 Transitional care management services for problem of at least moderate complexity	45	36	$250.00	$156.89
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	43	38	$115.00	$104.41
99220 Hospital observation care, typically 70 minutes	31	27	$185.00	$181.38
G0009 Administration of pneumococcal vaccine	30	30	$30.00	$15.22
99291 Critical care, first 30-74 minutes	27	24	$260.00	$218.75
99217 Hospital observation care on day of discharge	24	21	$110.00	$71.05
82962 Blood glucose (sugar) test performed by hand-held instrument	23	17	$16.00	$3.21
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	20	20	$117.50	$102.15
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	17	17	$185.00	$164.42
J1020 Injection, methylprednisolone acetate, 20 mg	15	14	$27.00	$3.78
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	15	15	$175.00	$159.54
81002 Urinalysis, manual test	14	14	$25.00	$3.41
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	14	14	$110.00	$50.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	666	213	$85.00	$68.26
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	264	69	$85.00	$69.32
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	152	50	$110.00	$99.30
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	118	118	$131.53	$108.41
85610 Blood test, clotting time	112	20	$30.00	$4.75
99239 Hospital discharge day management, more than 30 minutes	91	65	$135.00	$102.11
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	72	16	$55.00	$19.86
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	68	56	$205.00	$193.19
G0008 Administration of influenza virus vaccine	58	58	$25.00	$19.30
82962 Blood glucose (sugar) test performed by hand-held instrument	56	27	$16.00	$3.21
Q2035 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria)	42	42	$30.00	$17.88
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	37	31	$115.00	$100.68
G0009 Administration of pneumococcal vaccine	28	28	$30.00	$19.30
J1020 Injection, methylprednisolone acetate, 20 mg	26	21	$27.00	$5.12
99495 Transitional care management services for problem of at least moderate complexity	23	21	$250.00	$152.96
99220 Hospital observation care, typically 70 minutes	21	18	$185.00	$177.36
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	17	17	$185.00	$160.19
90756 Vaccine for influenza for injection into muscle	16	16	$35.00	$22.33
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	15	15	$100.00	$98.00
99291 Critical care, first 30-74 minutes	15	11	$260.00	$212.96
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	14	12	$110.00	$50.07
90670 Pneumococcal vaccine for injection into muscle	13	13	$203.85	$194.72

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	752	240	$85.00	$67.70
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	258	80	$85.00	$67.91
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	177	62	$110.00	$98.20
85610 Blood test, clotting time	124	24	$30.00	$5.28
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	120	120	$131.50	$106.13
82962 Blood glucose (sugar) test performed by hand-held instrument	100	36	$16.00	$3.15
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	97	24	$55.00	$18.43
99239 Hospital discharge day management, more than 30 minutes	96	70	$135.00	$100.69
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	71	58	$205.00	$189.78
G0008 Administration of influenza virus vaccine	67	67	$25.00	$23.76
Q2035 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria)	67	67	$30.00	$17.34
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	56	43	$115.00	$99.48
G0009 Administration of pneumococcal vaccine	45	45	$30.00	$23.76
J1020 Injection, methylprednisolone acetate, 20 mg	36	34	$27.00	$5.06
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	26	26	$185.00	$157.23
90670 Pneumococcal vaccine for injection into muscle	23	23	$200.00	$185.34
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	22	22	$98.64	$92.62
99220 Hospital observation care, typically 70 minutes	22	21	$185.00	$174.74
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	$110.00	$49.53
99291 Critical care, first 30-74 minutes	18	18	$260.00	$211.23
81002 Urinalysis, manual test	18	15	$25.00	$3.17
99217 Hospital observation care on day of discharge	16	15	$110.00	$68.23
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	13	13	$175.00	$152.88
93880 Ultrasound of both sides of head and neck blood flow	12	12	$275.00	$131.70
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$169.55	$153.12

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License OH 35085218

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

2715708 (OH)

Commercial Insurance / Payer ID Caresource

311513392031 (OH)

Commercial Insurance / Payer ID Anthem

000000480108 (OH)

Commercial Insurance / Payer ID Unison

000000248094 (OH)

Commercial Insurance / Payer ID Wellcare

450294 (OH)

Commercial Insurance / Payer ID Aetna

7745806 (OH)

Hospital & Practice Group Affiliations

S And J Med Inc

2760 Parkman Rd Nw, Warren, OH 444851635

Phone: 3308981723

Practice Associates & Co-Workers

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

2 Associated Practitioners

Dr. Ramona Sheth , MD

Internal Medicine

NPI 1285625194

Doctor of Medicine (M.D.)

Dr. Yogesh Sheth , MD

Internal Medicine

NPI 1467449371

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active July 30, 2012

NPI status registered as active in NPPES database

📍

Updated Practice Location July 30, 2012

Registered at 940 ROBBINS AVE, NILES, OH 444462468 (Tel: 3306527973)

📍

Updated Business Mailing Address July 30, 2012

Registered at 940 ROBBINS AVEVNUE, NILES, OH 444462468 (Tel: 3306527973)

👤

Provider Name / Credentials Updated July 30, 2012

Recorded as SANJAY SHETH, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 30, 2012

Internal Medicine (License #35085218 in OH)

🟢

Initial NPI Registration & Enumeration November 16, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1285616383

Entity Type:

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

Enumeration Date: November 16, 2005

Last Update: July 30, 2012

Sole Proprietor: No

Update or Correct Profile

Mailing Address

940 Robbins Avevnue

Niles, OH 444462468

Phone: 3306527973

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.