Medicare billing address
CMS Medicare provider billing file
904 Sumneytown Pike Ste 101Spring House, PA 19002
CMS public data · NPI 1770558413
Dr. Sanjay Shah: Medicare prescribing and billing data
CMS public files list billing, prescribing, location, and participation fields for this NPI. Current plan networks, appointment availability, clinical outcomes, and patient-specific medical advice require separate verification.
CMS display name
Sanjay Shah, MD
Specialty
Credential
MD
NPI
1770558413
Primary source state
PA
Data retrieval date
July 27, 2026
What related Medicare data is on this site?
Pennsylvania doctorsState Doctor hubAnesthesiologyState-specialty hubSpring House, PAPrimary city link if this route exists
Where these numbers come from, and what they cannot tell you
Public CMS records, 2024 reporting year. These are historical Medicare fields, not proof of current coverage, appointment availability, quality, or what someone will pay.
How should you read this Doctor page?
This page shows Medicare billing and Part D prescribing data for Sanjay Shah, MD from CMS public files. It covers 2024 claims data: services billed, the beneficiary panel, and the most-prescribed Part D drugs. It does not show current coverage, appointment availability, or quality ratings.
A licensed agent, not a call center
Do your doctors and prescriptions fit before you enroll?
Peter Abilla, Licensed Medicare Insurance Sales Agent, NPN 22265186. Bring the doctors and prescriptions that matter to you, then check the details before you enroll.
What Medicare source indicators are listed for this NPI?
Medicare participating
Yes
Individual assignment
Yes
Group assignment
Yes
CMS opt-out records
0
Which practice locations appear in CMS files?
When CMS files list more than one address for the same NPI, each address stays tied to the CMS file that reported it.
Spring House, PA 19002
SE PAIN MANAGEMENT, LTD
CMS Doctors & Clinicians file
1200 Old York RdAbington, PA 19001
PHOENIX REHABILITATION AND HEALTH SERVICES INC
CMS Doctors & Clinicians file
2000 Westinghouse DrSuite 200
Cranberry Twp, PA 16066
NOVACARE OUTPATIENT REHABILITATION EAST, INC.
CMS Doctors & Clinicians file
201 2Nd AveCollegeville, PA 19426
What does the Medicare billing file show?
In the 2024 CMS provider billing file, this NPI had 1,139 Medicare beneficiaries and 31,705 total services. The average beneficiary age was 69, and the average HCC risk score was 1.4.
Total Medicare allowed amount
$1,278,035.39
Total Medicare payment amount
$1,031,852.75
Medicare beneficiaries
1,139
Total services
31,705
Which patient-panel condition fields does CMS report?
These percentages describe the Medicare beneficiary panel in the CMS utilization file. They are not a diagnosis for any individual patient and are not a quality score.
Hyperlipidemia
75%
CMS beneficiary-panel share
Hypertension
75%
CMS beneficiary-panel share
Anxiety
45%
CMS beneficiary-panel share
Mood disorders
42%
CMS beneficiary-panel share
Depression
38%
CMS beneficiary-panel share
Diabetes
29%
CMS beneficiary-panel share
Where these service numbers come from, and what they cannot tell you
Amounts shown are average Medicare-approved amounts per billed unit in CMS records. What a person pays depends on current coverage and cannot be read from this table alone.
Which Medicare services appear most often?
| CMS service description | Services | Avg allowed |
|---|---|---|
| Injection, bupivicaine, not otherwise specified, 0.5 mg | 8,550 | $0.01 |
| Injection, methylprednisolone acetate, 1 mg | 6,240 | $0.13 |
| Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 3,342 | $130.33 |
| Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 3,149 | $0.97 |
| Assessment of emotional or behavioral problems | 1,792 | $4.79 |
| Testing for presence of drug, by chemistry analyzers | 917 | $60.61 |
| Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 515 | $111.76 |
| Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 468 | $63.88 |
| Injection of substance into lower spine canal using imaging guidance | 299 | $264.46 |
| Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml | 281 | $0.36 |
Where these Part D numbers come from, and what they cannot tell you
CMS data reports historical prescription drug events attributed to NPI 1770558413. Formularies, copays, prior authorization, and step therapy rules vary by current coverage.
Which drugs did Sanjay Shah, MD prescribe most often under Medicare Part D?
| Rank | Drug | Generic name | Total claims | 30-day fills | Total drug cost |
|---|---|---|---|---|---|
| 1 | Oxycodone-Acetaminophen | Oxycodone Hcl/Acetaminophen | 1,658 | 1,660.2 | $34,699.82 |
| 2 | Oxycodone Hcl | Oxycodone Hcl | 1,289 | 1,289 | $26,696.40 |
| 3 | Gabapentin | Gabapentin | 1,072 | 1,150.1 | $9,044.68 |
| 4 | Morphine Sulfate Er | Morphine Sulfate | 554 | 554 | $11,487.50 |
| 5 | Hydrocodone-Acetaminophen | Hydrocodone/Acetaminophen | 539 | 539 | $14,975.28 |
| 6 | Tramadol Hcl | Tramadol Hcl | 436 | 436 | $2,157.35 |
| 7 | Tizanidine Hcl | Tizanidine Hcl | 410 | 432 | $2,670.40 |
| 8 | Pregabalin | Pregabalin | 390 | 416 | $7,797.21 |
| 9 | Cyclobenzaprine Hcl | Cyclobenzaprine Hcl | 283 | 294 | $1,383.11 |
| 10 | Fentanyl | Fentanyl | 148 | 148 | $14,178.21 |
CMS Part D records are historical aggregate claims data. They do not include current formulary status, pharmacy price, prior-authorization rules, network-directory status, or clinical-outcome data.
What background fields does CMS report?
Medical school
Ponce School Of Medicine
Graduation year
2001
Group/practice field
Se Pain Management, Ltd
Telehealth reported
Yes
Secondary specialty fields reported by CMS: Pain Management.
What can this data not tell us?
- Billing data and prescribing data come from different CMS files. Neither one measures clinical outcomes, and neither one tells you whether this doctor is in a specific plan's network.
- Part D records do not report current medication use, plan coverage, price, pharmacy availability, or plan-directory status.
- Where CMS withholds a count for privacy, we show that note instead of a number. A withheld count is not zero.
- CMS billing data does not list Medicare Advantage plan-directory status for this doctor.
- CMS service and prescribing records are historical public-use aggregates; they do not report current appointment availability, clinical outcomes, or patient-specific medical advice.
- Part D provider-and-drug records do not include current formulary status, copay amount, pharmacy price, prior-authorization rules, or step-therapy rules.
What should you verify separately?
Verify plan-directory status, drug formulary rules, pharmacy pricing, appointment availability, and clinical questions against current plan documents and the relevant provider or care team.
Which CMS sources support this page?
The numbers above come from CMS public-use files for this NPI. Each link identifies the CMS release used and the retrieval date.
- Medicare Physician & Other Practitioners - by Provider · 1 records for this NPI · retrieved July 27, 2026
- Medicare Physician & Other Practitioners - by Provider and Service · 52 records for this NPI · retrieved July 27, 2026
- Doctors and Clinicians National Downloadable File · 7 records for this NPI · retrieved July 27, 2026
- Opt-Out Affidavits · 0 records for this NPI · retrieved July 27, 2026
- Medicare Part D Prescribers - by Provider and Drug · 45 records for this NPI · retrieved July 27, 2026
What caveats apply to this page?
- CMS billing and utilization files do not list Medicare Advantage plan networks, appointment availability, or clinical outcomes.
- Part D provider-and-drug files are historical aggregate claims data; they do not report current medication lists, plan coverage, pharmacy price, or prior-authorization rules.
- Where CMS withholds a count for privacy, we show that note instead of a number. A withheld count is not zero.