Physician

Sumit P. Shah, M.D.

According to 2025 Medicare claims, Sumit Shah, M.D. (NPI: 1346439213) practices ophthalmology in the Lakewood-New Brunswick, NJ market, with the plurality of this provider's patient population coming from Somerset, NJ. This provider's primary affiliated billing organization is ASSOCIATED RETINAL CONSULTANTS LLC (NPI: 1164578894; TIN: 208346981) and primary practice location at 08807-2943. Shah is affiliated with the Physician Leaders Direct Contracting Entity, LLC (ACO ID: D0171) and Vytalize Health 9 ACO LLC (ACO ID: D0313), participating under the REACH model.

Shah's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 842 traditional Medicare patients, billed 32,694 HCPCS/CPT codes, and received $4,194,811 in Medicare payments. The top billing code was 92014 (Established patient complete exam of visual system). Part D data shows 620 prescription claims across 147 beneficiaries totaling $56,801 in drug costs, led by Prolensa (Bromfenac Sodium). Open Payments data shows 27 records totaling $43,328. 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 moved up and down with repeated peaks and valleys, starting at $47,274 and ending at $56,801. For DME billing, this provider has fewer than 5 years of reported data, so a reliable trend cannot be assigned.

Part B Carrier Billing Trend

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

Year	Patients	Clm Lines	Payment
2015	1,390	21,046	$3,849,358
2016	1,433	22,752	$4,615,156
2017	1,307	21,686	$4,108,672
2018	1,181	20,063	$3,792,272
2019	1,007	16,650	$3,204,719
2020	871	16,666	$3,773,708
2021	793	15,987	$3,589,103
2022	797	18,988	$3,646,548
2023	1,021	35,342	$4,196,822
2024	842	32,694	$4,194,811

Part D Events Trend

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

Year	Patients	Claims	Drug Cost
2015	162	584	$47,274
2016	170	657	$69,686
2017	180	644	$73,730
2018	183	684	$65,369
2019	181	696	$65,182
2020	179	745	$71,857
2021	170	639	$70,917
2022	150	456	$41,227
2023	154	595	$66,596
2024	147	620	$56,801

DME Billing Trend

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

No connected DME records

* / # = 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
92014	Established patient complete exam of visual system	707	2,031	$108
67028	Injection of drug into eye	361	2,170	$104
92012	Established patient problem focused exam of visual system	166	358	$78
92134	Imaging of retina	769	2,409	$37
92202	Extended exam of the back part of the eye with optic nerve drawing	322	461	$13

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Prolensa	Bromfenac Sodium	68	2,151	$27,177
Prednisolone Acetate	Prednisolone Acetate	138	4,880	$5,618
Lumigan	Bimatoprost	12	470	$3,923
Bromfenac Sodium	Bromfenac Sodium	13	349	$3,004
Difluprednate	Difluprednate	13	126	$1,179

Top 5 DME services in 2024

No connected or detailed DME service-level records for 2024.

Open Payments Summary in 2024

Category	Definition	Records	Total Reported Amount	Top Related Entity
General Payments	Reported payment or transfer-of-value amount.	23	$25,543	Regeneron Healthcare Solutions, Inc.
Research Payments	Reported research-related payment or transfer-of-value amount.	4	$17,785	Genentech, Inc.
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 Sumit P. Shah, M.D.?

Tedicare shows public-source Medicare data for Sumit P. Shah, M.D. (NPI 1346439213), 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 Sumit P. Shah, M.D. have ACO affiliation data?

Sumit P. Shah, M.D. is shown with ACO affiliation data for Physician Leaders Direct Contracting Entity, LLC (REACH, ACO ID D0171) and Vytalize Health 9 ACO LLC (REACH, ACO ID D0313).

What billing organization is linked to Sumit P. Shah, M.D.?

Sumit P. Shah, M.D. is linked to ASSOCIATED RETINAL CONSULTANTS LLC (billing NPI 1164578894) in the available physician profile data.

Does Sumit P. Shah, M.D. have Open Payments data?

Sumit P. Shah, M.D. has 27 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.