Active NPI 1386968022 Individual Practitioner Male Practitioner

Dr. Niraj Shirish Shah , MD

Ophthalmology • Toledo, OH

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Niraj Shah, MD is a certified Ophthalmology practicing in Toledo, OH. 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 2865 N REYNOLDS RD.

Dr. Shah is affiliated with Promedica Central Physicians and accepts Medicare assignment.

Frequently performed procedures and clinical services include injection, faricimab-svoa, 0.1 mg, injection, aflibercept, 1 mg, imaging of retina. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

2865 N Reynolds Rd
Suite 170

Toledo, OH 436152068

Telephone 4195782020

Fax 4195396323

Associated Practice Facility / Clinic

🏢 Retina Vitreous Associates Inc Facility NPI 1922073030

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 Ophthalmology in Toledo, OH

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

16 Yrs -12.4 yrs vs City Avg

City Avg: 28.4 Yrs

State Avg: 27.9 Yrs

Regional Practice Density

35 Specialists

Practicing in Toledo, OH (803 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

58.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Shah (16 Years) 16 Yrs

Toledo Specialty Average (28.4 Years) 28.4 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
J2777 Injection, faricimab-svoa, 0.1 mg	4,680	20	$56.92	$32.64
J0178 Injection, aflibercept, 1 mg	2,872	197	$1794.99	$816.59
92134 Imaging of retina	2,694	1,028	$89.00	$38.56
67028 Injection of drug into eye	1,511	286	$382.82	$121.10
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,049	670	$179.00	$124.83
92250 Photography of the retina	534	521	$169.00	$35.49
99213 Established patient office or other outpatient visit, typically 15 minutes	473	352	$127.00	$87.29
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	239	239	$315.00	$163.64
J3590 Unclassified biologics	214	58	$95.82	$57.60
92012 Established patient problem focused exam of visual system	29	29	$140.00	$82.83
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	24	22	$38.00	$16.24
67108 Repair of detached retina and drainage of eye fluid between lens and retina	20	16	$2522.00	$1033.77
67042 Removal of membrane of retina with removal of internal limiting membrane of retina	20	20	$3069.00	$1096.23
67036 Removal of eye fluid (vitreous) between the lens and retina	17	16	$1947.00	$709.40
66821 Removal of recurring cataract in lens capsule using a laser	14	11	$668.00	$319.30
67113 Complex repair of detached retina and drainage of eye fluid between lens and retina	13	12	$2743.00	$1251.74

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92134 Imaging of retina	2,141	820	$135.00	$37.55
J0178 Injection, aflibercept, 1 mg	1,348	170	$1683.20	$844.99
67028 Injection of drug into eye	1,248	217	$274.79	$113.75
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	876	543	$165.00	$119.99
99213 Established patient office or other outpatient visit, typically 15 minutes	714	262	$112.00	$84.91
J3590 Unclassified biologics	645	116	$94.06	$56.85
92250 Photography of the retina	270	264	$136.00	$34.80
92012 Established patient problem focused exam of visual system	150	134	$140.00	$84.33
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	132	132	$315.00	$158.39
66821 Removal of recurring cataract in lens capsule using a laser	23	19	$668.00	$302.28
67042 Removal of membrane of retina with removal of internal limiting membrane of retina	20	19	$3069.00	$1073.70

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92134 Imaging of retina	1,745	625	$135.00	$38.21
67028 Injection of drug into eye	1,152	181	$241.32	$107.59
99213 Established patient office or other outpatient visit, typically 15 minutes	830	253	$112.00	$86.44
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	716	471	$165.00	$123.12
J0178 Injection, aflibercept, 1 mg	712	46	$1500.00	$901.43
J3590 Unclassified biologics	697	126	$100.97	$59.01
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	93	93	$315.00	$162.49
92012 Established patient problem focused exam of visual system	84	76	$140.00	$84.73
92250 Photography of the retina	58	58	$136.00	$35.60
92201 Extended exam of the back part of the eye with retinal drawing	14	14	$50.00	$22.14
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$167.00	$99.02

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92134 Imaging of retina	1,575	555	$114.62	$39.18
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	999	538	$192.12	$125.98
67028 Injection of drug into eye	936	153	$474.90	$110.06
J0178 Injection, aflibercept, 1 mg	652	50	$1334.12	$919.00
J3590 Unclassified biologics	522	101	$125.46	$60.00
99213 Established patient office or other outpatient visit, typically 15 minutes	470	224	$124.22	$88.43
92250 Photography of the retina	107	106	$143.67	$37.60
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	73	73	$317.67	$164.49
92201 Extended exam of the back part of the eye with retinal drawing	27	27	$81.48	$24.28
92012 Established patient problem focused exam of visual system	24	22	$156.29	$86.19

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92134 Imaging of retina	1,413	520	$99.81	$39.48
67028 Injection of drug into eye	788	148	$654.18	$100.21
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	774	469	$208.00	$106.41
J0178 Injection, aflibercept, 1 mg	692	56	$1252.05	$930.90
99213 Established patient office or other outpatient visit, typically 15 minutes	555	222	$140.93	$73.59
J3590 Unclassified biologics	393	99	$143.28	$59.73
92250 Photography of the retina	96	95	$147.43	$43.49
92012 Established patient problem focused exam of visual system	68	62	$163.00	$85.58
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	56	56	$320.00	$157.66
92201 Extended exam of the back part of the eye with retinal drawing	30	30	$98.33	$25.04
67041 Removal of membrane from the retina	14	13	$3000.00	$1068.11

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92134 Imaging of retina	1,268	480	$99.62	$39.15
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	679	421	$208.00	$104.39
67028 Injection of drug into eye	659	138	$654.00	$98.20
99213 Established patient office or other outpatient visit, typically 15 minutes	531	231	$141.00	$71.09
J0178 Injection, aflibercept, 1 mg	400	36	$1256.25	$942.55
J3590 Unclassified biologics	396	97	$144.00	$58.20
92250 Photography of the retina	110	109	$148.07	$47.69
92012 Established patient problem focused exam of visual system	106	87	$163.00	$84.97
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	71	71	$320.00	$160.58
92225 Examination of eye by ophthalmoscope with retinal drawing	20	20	$76.00	$26.88
76512 Ultrasound of eye disease, growth, or structure	18	16	$178.00	$58.22
67145 Photocoagulation treatment to prevent detachment of retina	11	11	$1231.00	$515.31

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92134 Imaging of retina	987	352	$99.96	$39.53
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	695	380	$207.89	$102.67
67028 Injection of drug into eye	587	125	$654.00	$98.18
99213 Established patient office or other outpatient visit, typically 15 minutes	488	223	$141.00	$69.89
J0178 Injection, aflibercept, 1 mg	360	34	$1253.95	$953.08
J3590 Unclassified biologics	340	86	$144.00	$58.65
J7312 Injection, dexamethasone, intravitreal implant, 0.1 mg	154	12	$389.61	$197.08
92250 Photography of the retina	124	123	$148.18	$52.92
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	61	61	$320.00	$156.67
92012 Established patient problem focused exam of visual system	45	39	$163.00	$83.40
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	17	15	$83.00	$41.94
92225 Examination of eye by ophthalmoscope with retinal drawing	11	11	$76.00	$26.20

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92134 Imaging of retina	707	256	$98.27	$38.80
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	576	268	$206.30	$102.75
67028 Injection of drug into eye	422	110	$457.26	$97.61
99213 Established patient office or other outpatient visit, typically 15 minutes	302	167	$138.07	$69.36
J0178 Injection, aflibercept, 1 mg	234	28	$1312.68	$961.96
J3590 Unclassified biologics	229	79	$125.66	$59.04
92250 Photography of the retina	91	90	$146.75	$60.86
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	42	42	$312.29	$158.18
76512 Ultrasound of eye disease, growth, or structure	19	16	$186.11	$86.95
92235 Exam of retinal blood vessels using a special camera after injection of a dye	18	18	$200.00	$73.92
92225 Examination of eye by ophthalmoscope with retinal drawing	16	16	$76.00	$25.82
67145 Photocoagulation treatment to prevent detachment of retina	14	13	$1148.50	$503.31

Medical Specialties & State Licenses

Ophthalmology Primary Specialty

NUCC Taxonomy Code: 207W00000X

State License OH 35123889

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

0106080 (OH)

Hospital & Practice Group Affiliations

Promedica Central Physicians

2865 N Reynolds Rd, Toledo, OH 436152100

Phone: 4195787200

Practice Associates & Co-Workers

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

16 Associated Practitioners

Dr. John Burchfield , MD

Ophthalmology

NPI 1144292566

Doctor of Medicine (M.D.)

Dr. Gerald Striph , MD

Ophthalmology

NPI 1275505315

Doctor of Medicine (M.D.)

Dr. Brian Chinavare , MD

Ophthalmology

NPI 1568455806

Doctor of Medicine (M.D.)

Dr. Jeffery Stephens , MD

Ophthalmology

NPI 1578535399

Doctor of Medicine (M.D.)

Dr. Rodney Mccarthy , MD

Ophthalmology

NPI 1578535738

Doctor of Medicine (M.D.)

Dr. Jenna Bailey , OD

Optometrist

NPI 1659891943

Doctor of Optometry

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active August 04, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location August 04, 2016

Registered at 2865 N REYNOLDS RD, SUITE 170, TOLEDO, OH 436152068 (Tel: 4195782020)

📍

Updated Business Mailing Address August 04, 2016

Registered at 2865 N REYNOLDS RD, SUITE 170, TOLEDO, OH 436152068 (Tel: 4195782020)

👤

Provider Name / Credentials Updated August 04, 2016

Recorded as NIRAJ SHAH, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) August 04, 2016

Ophthalmology (License #35123889 in OH)

🟢

Initial NPI Registration & Enumeration March 24, 2010

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: 1386968022

Entity Type:

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

Enumeration Date: March 24, 2010

Last Update: November 03, 2023

Sole Proprietor: No

Update or Correct Profile

Mailing Address

2865 N Reynolds Rd, Suite 170

Toledo, OH 436152068

Phone: 4195782020

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.