Physician

Nirav A Sheth, MD

According to 2025 Medicare claims, Nirav Sheth, MD (NPI: 1134137144) practices internal medicine in the Bowling Green, KY market, with the plurality of this provider's patient population coming from Warren, KY. This provider's primary affiliated billing organization is GRAVES GILBERT CLINIC PLLC (NPI: 1114948288; TIN: 610700826) and primary practice location at 42104-7897. Sheth is affiliated with the Caravan Collaborative Pathways (ACO ID: A4604) and GGC ValueCare LLC (ACO ID: A5611), participating under the MSSP model.

Sheth's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 1,099 traditional Medicare patients, billed 14,154 HCPCS/CPT codes, and received $760,828 in Medicare payments. The top billing code was G0439 (Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit). Part D data shows 43,339 prescription claims across 1,421 beneficiaries totaling $2,843,948 in drug costs, led by Eliquis (Apixaban). DME data shows 950 claims. Open Payments data shows 65 records totaling $1,124. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing has changed little. Concurrently, Part D prescription costs have risen steadily, from $1,850,288 to $2,843,948. In contrast, DME billing represents a smaller volume and changed little.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	1,466	21,763	$784,802
2016	1,513	19,562	$806,344
2017	1,510	25,620	$814,079
2018	1,500	26,594	$835,872
2019	1,481	25,076	$834,392
2020	1,320	21,618	$741,610
2021	1,227	16,346	$651,946
2022	1,201	14,562	$640,079
2023	1,070	13,373	$644,321
2024	1,099	14,154	$760,828

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	1,121	34,277	$1,850,288
2016	1,098	34,722	$1,809,727
2017	1,127	32,300	$1,817,233
2018	1,141	28,973	$1,695,645
2019	1,222	30,048	$1,815,374
2020	1,242	30,567	$1,847,106
2021	1,192	29,444	$2,117,477
2022	1,356	32,444	$2,422,622
2023	1,372	39,305	$3,071,699
2024	1,421	43,339	$2,843,948

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	287	1,326	$75,499
2016	311	1,424	$80,898
2017	297	1,079	$62,057
2018	272	1,017	$70,391
2019	269	1,190	$62,354
2020	217	1,088	$55,589
2021	213	856	$39,702
2022	192	870	$41,427
2023	238	911	$44,721
2024	241	950	$48,510

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	287	287	$123
99305	Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	449	580	$97
99309	Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	669	3,461	$78
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	305	885	$75
85025	Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	277	528	$8

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Eliquis	Apixaban	1,299	27,712	$563,684
Januvia	Sitagliptin Phosphate	377	11,675	$222,224
Jardiance	Empagliflozin	163	4,326	$88,774
Trelegy Ellipta	Fluticasone/Umeclidin/Vilanter	108	3,542	$78,876
Ozempic	Semaglutide	69	2,094	$72,894

Top 5 DME services in 2024

By Total Medicare Payment Amount.

HCPCS Code	HCPCS Description	Supplier Rental Indicator	Total Supplier Beneficiaries	Total Supplier Claims	Total Medicare Payment Amount
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	Y	15	123	$8,596
A5513	For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each	N	23	23	$5,714
E0260	Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress	Y	18	103	$5,359
K0001	Standard wheelchair	Y	51	270	$5,344
A5500	For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe	N	38	38	$4,980

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	65	$1,124	ABBVIE INC.
Research Payments	Reported research-related payment or transfer-of-value amount.	0	$0	N/R
Ownership / Investment Interests	Reported value of ownership or investment interests.	0	$0	N/R

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FAQ

What Medicare data is available for Nirav A. Sheth, MD?

Tedicare shows public-source Medicare data for Nirav A. Sheth, MD (NPI 1134137144), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Nirav A. Sheth, MD have ACO affiliation data?

Nirav A. Sheth, MD is shown with ACO affiliation data for Caravan Collaborative Pathways (MSSP, ACO ID A4604) and GGC ValueCare LLC (MSSP, ACO ID A5611).

What billing organization is linked to Nirav A. Sheth, MD?

Nirav A. Sheth, MD is linked to GRAVES GILBERT CLINIC PLLC (billing NPI 1114948288) in the available physician profile data.

Does Nirav A. Sheth, MD have Open Payments data?

Nirav A. Sheth, MD has 65 connected Open Payments records in the available 2024 summary data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.