Physician
Sheldon Medical Care,pc
Sheldon Medical Care,pc was paid $1.25M by Medicaid between Jan 2018 and Nov 2024, across 46 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 63% of everything it billed.
33Billing provider infoSHELDON MEDICAL CARE,PC
BRONX, NY 10468
BRONX, NY 10468
33aNPI1013900463assigned 08/31/2005
33bProvider typeInternal Medicine Physician
28Total paid$1.25M
24GClaims89,269
24DCodes billed46
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Internal Medicine Physician providers in New York
Rank by total paid#235 of 6,049
Median peer was paid$11K
This provider vs. median110×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 17,996 | $694K | |
| 2019 | 19,626 | $414K | |
| 2020 | 17,406 | $77K | |
| 2021 | 10,397 | $38K | |
| 2022 | 3,711 | $8K | |
| 2023 | 10,751 | $9K | |
| 2024incomplete | 9,382 | $5K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 63% | 47,791 | 37,696 | $785K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 11% | 863 | 862 | $139K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 6.7% | 4,116 | 4,094 | $84K |
| 93880 | 5.0% | 427 | 426 | $62K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 4.2% | 2,431 | 2,423 | $52K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.9% | 414 | 413 | $37K |
| 83013 | 2.4% | 408 | 402 | $31K | |
| 93000 | 1.9% | 1,704 | 1,692 | $24K | |
| 99385 | <1% | 326 | 326 | $4K | |
| 93975 | <1% | 30 | 30 | $4K | |
| 93925 | <1% | 14 | 14 | $3K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 105 | 97 | $3K |
34 more codes
| 95923 | <1% | 34 | $3K | |
| 93015 | <1% | 53 | $3K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 5,520 | $2K |
| 95943 | <1% | 31 | $2K | |
| 81003 | <1% | 1,615 | $2K | |
| 86580 | <1% | 329 | $2K | |
| 93351 | <1% | 12 | $1K | |
| 99386 | <1% | 86 | $1K | |
| 83014 | <1% | 407 | $955.00 | |
| 99406 | <1% | 255 | $852.57 | |
| 87490 | <1% | 142 | $281.05 | |
| 3079F | <1% | 108 | $217.50 | |
| 3074F | <1% | 61 | $140.00 | |
| 3078F | <1% | 53 | $117.50 | |
| 3075F | <1% | 53 | $112.50 | |
| 3051F | <1% | 16 | $20.00 | |
| 1036F | 0% | 1,145 | $0.00 | |
| 1000F | 0% | 1,434 | $0.00 | |
| G9275 | Documentation that patient is a current non-tobacco user | 0% | 3,656 | $0.00 |
| 1101F | 0% | 176 | $0.00 | |
| H0001 | Alcohol and/or drug assessment | 0% | 2,783 | $0.00 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 6,307 | $0.00 |
| 4000F | 0% | 53 | $0.00 | |
| 1100F | 0% | 179 | $0.00 | |
| 3725F | 0% | 1,742 | $0.00 | |
| 3288F | 0% | 180 | $0.00 | |
| G9622 | Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method | 0% | 2,645 | $0.00 |
| 1159F | 0% | 132 | $0.00 | |
| 3016F | 0% | 1,239 | $0.00 | |
| 99408 | 0% | 69 | $0.00 | |
| 1160F | 0% | 82 | $0.00 | |
| G9276 | Documentation that patient is a current tobacco user | 0% | 13 | $0.00 |
| 3015F | 0% | 15 | $0.00 | |
| G9820 | Documentation of a chlamydia screening test with proper follow-up | 0% | 15 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialSHAH, TUSHAR (PRESIDENT)