PARTH SHAH MD
NPI 1548722713
Hospitalist in Alton, IL

NPI Status: Active since April 04, 2019

Contact Information

1 MEMORIAL DR
ALTON, IL
ZIP 62002
Phone: (618) 463-7240

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  • Individual
  • Male
  • Years of Experience 8
  • Hospitalist
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About PARTH SHAH

This page provides the complete NPI Profile along with additional information for Parth Shah, a provider established in Alton, Illinois with a medical specialization in Hospitalist and more than 8 years of experience. He graduated from University Of Illinois College Of Med (chi/peor/rock/chm-urb) in 2018. The healthcare provider is registered in the NPI registry with number 1548722713 assigned on April 2019. The practitioner's primary taxonomy code is 208M00000X with license number 036159727 (IL). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI
1548722713
Provider Name
PARTH SHAH MD
Gender
Male
Entity Type
Individual
Location Address
1 MEMORIAL DR ALTON, IL 62002
Location Phone
(618) 463-7240
Mailing Address
300 RANDALL RD GENEVA, IL 60134
Mailing Phone
(630) 933-4700
Mailing Fax
Medical School Name
UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduation Year
2018
Is Sole Proprietor?
No
Enumeration Date
04-04-2019
Last Update Date
09-20-2024
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Location Map

Secondary Locations

  • 1710 Harrison St
    Batesville, AR 72501
    (870) 262-1200
  • 300 Randall Rd
    Geneva, IL 60134
    (630) 933-4700

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Hospitalist

Taxonomy Code
208M00000X
Type
Allopathic & Osteopathic Physicians
License No.
036159727
License State
IL
Taxonomy Description
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207R00000XAllopathic & Osteopathic Physicians

Internal Medicine

036159727 (IL)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Bronze 1 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - HMO
  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - HMO
  • Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision + Rx Copay - HMO
  • Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
  • Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - HMO
  • Silver 5 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision + Rx Copay - HMO
  • Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
  • Blue Choice Preferred Bronze PPO? 201 - PPO
  • Blue Choice Preferred Bronze PPO? 701 - PPO
  • Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
  • Blue Choice Preferred Gold PPO? 204 - PPO
  • Blue Choice Preferred Gold PPO? 901 - PPO
  • Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
  • Blue Choice Preferred Security PPO? 200 - PPO
  • Blue Choice Preferred Silver PPO? 203 - PPO
  • Blue Choice Preferred Silver PPO? 801 - PPO
  • Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Parth Shah is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Parth Shah is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 7012241763

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20220829001814

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: No

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Follow-up hospital inpatient care per day, typically 25 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 175 times for 74 patients

Hospital discharge day management, more than 30 minutes

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

This service was performed 65 times for 62 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 31 times for 31 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $32.78 for a new patient copayment and $24.92 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 62002 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $131.14
  • Minimum New Patient Price $56.28
  • Maximum New Patient Price $173.35
  • Average New Patient Copayment $32.78
  • Minimum New Patient Copayment $14.07
  • Maximum New Patient Copayment $43.33

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $99.71
  • Minimum Established Patient Price $17.51
  • Maximum Established Patient Price $139.99
  • Average Established Patient Copayment $24.92
  • Minimum Established Patient Copayment $4.37
  • Maximum Established Patient Copayment $34.99

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Parth Shah is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
ALTON MEMORIAL HOSPITALONE MEMORIAL DRIVE
ALTON, IL 62002
(618) 463-7311Acute Care Hospitals
MEMORIAL HOSPITAL4500 MEMORIAL DRIVE
BELLEVILLE, IL 62226
(618) 233-7750Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1548722713
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2588142472
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 8 + 8 + 1 + 4 + 2 + 4 + 7 + 2 + 24 = 67
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 67 = 33

The NPI number 1548722713 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1659354678EDWARD J HARROW PTR, ALTON PATHOLOGY ASSOCIATES
Organization
Pathology (Anatomic Pathology & Clinical Pathology)1 MEMORIAL DR
ALTON, IL 62002
(618) 463-7410
1205810454 JEFFREY H KIVIAT M.D.
Individual
Pathology (Anatomic Pathology & Clinical Pathology)1 MEMORIAL DR
ALTON, IL 62002
(618) 463-7410
1649231838MR. KEVIN NORMAN REISECK ATC, CSCS
Individual
Specialist/Technologist (Athletic Trainer)1 MEMORIAL DR
ALTON, IL 62002
(618) 463-7529
1801857347MR. ANDREW MICHAEL RENNER ATC
Individual
Specialist/Technologist (Athletic Trainer)1 MEMORIAL DR
ALTON, IL 62002
(618) 463-7529
1780647842 DREW MILLER DINTELMANN ATC, CSCS
Individual
Specialist/Technologist (Athletic Trainer)1 MEMORIAL DR
ALTON, IL 62002
(618) 288-3078
1740239268 MARY K WEHKING RPH
Individual
Pharmacist1 MEMORIAL DR
ALTON, IL 62002
(618) 463-7833
1861442667MRS. SARA B ROBERTS RPH
Individual
Pharmacist1 MEMORIAL DR
ALTON, IL 62002
(618) 463-7833
1023033578 RODGER HANKO M.D.
Individual
Emergency Medicine1 MEMORIAL DR
ALTON, IL 62002
(618) 463-7311
1215952163BC ILLINOIS EMERGENCY PHYSICIANS, LLP
Organization
Emergency Medicine1 MEMORIAL DR
ALTON, IL 62002
(618) 463-7311
1033135272MS. SYLVIA G HOORMANN CRNA
Individual
Nurse Anesthetist, Certified Registered1 MEMORIAL DR
ALTON, IL 62002
(618) 463-7311
1700803335 DAVID RIESENBERGER M.D.
Individual
Emergency Medicine1 MEMORIAL DR
ALTON, IL 62002
(618) 463-7311
1346267978 CRAIG ROSENBERG M.D., FACP, FACEP
Individual
Emergency Medicine1 MEMORIAL DR
ALTON, IL 62002
(217) 464-2966
1124045752 DAVID WAYNE BURNSIDE M.D., MBA
Individual
Emergency Medicine1 MEMORIAL DR
ALTON, IL 62002
(618) 463-7311
1326065962 ALAN JOHNSON M.D.
Individual
Emergency Medicine1 MEMORIAL DR
ALTON, IL 62002
(618) 463-7311
1417974957 CAROL HURLEY M.D.
Individual
Emergency Medicine1 MEMORIAL DR
ALTON, IL 62002
(314) 434-0600
1457361065 SAMUEL J ESSMA MD
Individual
Radiology (Diagnostic Radiology)1 MEMORIAL DR ALTON MEMORIAL HOSPITAL
ALTON, IL 62002
(618) 463-7415
1609984319ALTON MEMORIAL HOSPITAL
Organization
Skilled Nursing Facility1 MEMORIAL DR
ALTON, IL 62002
(618) 463-7311
1275611618 LYNN A. BROWN F.N.P.
Individual
Nurse Practitioner (Family)1 MEMORIAL DR
ALTON, IL 62002
(618) 433-7066
1093858276FAIRVIEW HEIGHTS MEDICAL GROUP SC
Organization
Clinic/Center (Physical Therapy)1 MEMORIAL DR SUITE G204
ALTON, IL 62002
(618) 465-7887
1942344981FAIRVIEW HEIGHTS MEDICAL GROUP SC
Organization
Clinic/Center1 MEMORIAL DR 1ST FLOOR
ALTON, IL 62002
(618) 433-7066

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1548722713, enumerated in the NPI registry as an "individual" on April 04, 2019

The provider is located at 1 Memorial Dr Alton, Il 62002 and the phone number is (618) 463-7240

The provider's speciality is Hospitalist with taxonomy code 208M00000X

The provider has more than 8 years of experience. He graduated from University Of Illinois College Of Med (chi/peor/rock/chm-urb) in 2018.

The provider might be accepting Accepts: Aetna CVS Health and Blue Cross and Blue Shield of. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

Medicare beneficiaries should expect a typical cost of $131.14 with an average copayment of $32.78 for new patient appointments. Established patients should expect a typical charge of $99.71 and an average copayment of 24.92. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Follow-up hospital inpatient care per day, typically 25 minutes, Hospital discharge day management, more than 30 minutes and Initial hospital inpatient care per day, typically 70 minutes.

The practitioner is affiliated to the following hospital(s): ALTON MEMORIAL HOSPITAL and MEMORIAL HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on April 04, 2019. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.