Physician

Niraj Shah

According to 2025 Medicare claims, Niraj Shah (NPI: 1326300831) practices family practice in the Racine-Mount Pleasant, WI market, with the plurality of this provider's patient population coming from Racine, WI. This provider's primary affiliated billing organization is AURORA MEDICAL GROUP, INC. (NPI: 1427271378; TIN: 391678306) and primary practice location at 53406-3735. Shah is affiliated with the Advocate Physician Partners Accountable Care, Inc. (ACO ID: A1033) and Accountable Care Organization of Advocate Aurora Health, LLC (ACO ID: D0260), participating under both the MSSP and REACH models.

Shah's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 214 traditional Medicare patients, billed 993 HCPCS/CPT codes, and received $74,051 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 8,563 prescription claims across 610 beneficiaries totaling $604,008 in drug costs, led by Trulicity (Dulaglutide). DME data shows 136 claims. Open Payments data shows 1 records totaling $27. 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 risen steadily, from $11,452 to $74,051. Similarly, Part D prescription costs have moved sharply higher in recent years, from $18,663 to $604,008. In contrast, DME billing represents a smaller volume and rose steadily, from $3,776 to $16,467.

Part B Carrier Billing Trend

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

Year	Patients	Clm Lines	Payment
2015	89	216	$11,452
2016	129	712	$34,978
2017	148	663	$43,438
2018	188	722	$46,689
2019	238	1,203	$67,796
2020	228	1,128	$62,998
2021	210	1,174	$79,501
2022	205	1,013	$74,087
2023	207	916	$67,463
2024	214	993	$74,051

Part D Events Trend

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

Year	Patients	Claims	Drug Cost
2015	96	322	$18,663
2016	154	1,680	$120,176
2017	185	2,407	$145,636
2018	282	3,217	$217,146
2019	387	4,303	$289,354
2020	441	5,593	$410,790
2021	428	6,792	$598,262
2022	481	7,471	$713,002
2023	521	8,316	$797,763
2024	610	8,563	$604,008

DME Billing Trend

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

Year	Patients	Claims	Payment
2015	N/R	N/R	N/R
2016	N/R	N/R	N/R
2017	N/R	20	$463
2018	N/R	33	$567
2019	N/R	45	$584
2020	34	149	$3,651
2021	36	197	$8,011
2022	39	255	$9,585
2023	42	225	$9,451
2024	25	136	$5,079

* / # = 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	135	135	$117
90662	Influenza vaccine split virus, preservative free	48	50	$78
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	162	345	$78
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	108	139	$54
G0008	Administration of influenza virus vaccine	51	54	$30

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Trulicity	Dulaglutide	45	2,240	$76,628
Jardiance	Empagliflozin	42	2,022	$39,434
Eliquis	Apixaban	39	1,390	$27,425
Tradjenta	Linagliptin	17	1,490	$26,746
Januvia	Sitagliptin Phosphate	37	1,324	$25,529

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
A7030	Full face mask used with positive airway pressure device, each	N	N/R	20	$1,508
A4351	Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each	N	N/R	12	$1,263
A7031	Face mask interface, replacement for full face mask, each	N	N/R	18	$937
A4604	Tubing with integrated heating element for use with positive airway pressure device	N	N/R	14	$480
A7035	Headgear used with positive airway pressure device	N	12	18	$294

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	1	$27	Lundbeck LLC
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 Niraj Shah?

Tedicare shows public-source Medicare data for Niraj Shah (NPI 1326300831), 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 Niraj Shah have ACO affiliation data?

Niraj Shah is shown with ACO affiliation data for Advocate Physician Partners Accountable Care, Inc. (MSSP, ACO ID A1033) and Accountable Care Organization of Advocate Aurora Health, LLC (REACH, ACO ID D0260).

What billing organization is linked to Niraj Shah?

Niraj Shah is linked to AURORA MEDICAL GROUP, INC. (billing NPI 1427271378) in the available physician profile data.

Does Niraj Shah have Open Payments data?

Niraj Shah has 1 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.