2026 NPPES data Pediatrics Physician NPI 1245209832 MD
Verify on CMS →

KETAN SHETH, MD

Pediatrics Physician in LAFAYETTE, Indiana. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.

Federal data — no proprietary rating. PlainDoctor publishes the actual CMS NPPES and Medicare records — NPI registration, specialty, practice location, and prescribing data — without a composite score or editorial opinion on top. Every field traces to a federal source.
Prescribing volume
513
Medicare Part D claims · 68 beneficiaries · Pediatrics Physician avg: 762
Generic prescribing
37%
generic claims · 63% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
96.6822/100
▲ 14 pts above national avg 83.1 · [object Object]
Industry payments
$79.61
1 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

KETAN SHETH, MD reported a CMS MIPS final score of 96.6822/100 — above the 83.1 national average — and filed 513 Medicare Part D claims in 2023.

96.6822/100
MIPS score · +14 vs avg
513
Part D claims, 2023
37%
generic prescribing
Likely
board-certified (heuristic)

Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) — no proprietary rating or editorial opinion is applied.

KETAN SHETH, MD's MIPS score vs every scored U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023 — the federal quality measure

97 Top 17% higher than 83% of 477,587 scored providers

0–10: 8,684 scored providers (2%). Below this entry. 10–20: 3,008 scored providers (1%). Below this entry. 20–30: 3,069 scored providers (1%). Below this entry. 30–40: 2,746 scored providers (1%). Below this entry. 40–50: 2,928 scored providers (1%). Below this entry. 50–60: 5,882 scored providers (1%). Below this entry. 60–70: 13,906 scored providers (3%). Below this entry. 70–80: 118,074 scored providers (25%). Below this entry. 80–90: 129,887 scored providers (27%). Below this entry. 90–100: 189,403 scored providers (40%). This entry sits in this band. This provider 0 100 every MIPS-scored clinician, bucketed by value

Each bar is a band; taller bars hold more scored providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.

Source CMS Merit-based Incentive Payment System (MIPS) · 2023

Board certification likely (heuristic — not verified)

KETAN SHETH, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting — signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).

What does the federal data show about KETAN SHETH, MD?

High performer (top quartile)

NPI registry status

Active

Issued 03/16/2006

NPI 1245209832

Primary specialty

Pediatrics Physician

High-volume

80,574 US NPIs in this specialty

Medicare Part D claims

513 33% vs specialty avg

2023 prescription claims

Specialty avg: 762

MIPS final score

96.6822/100 13.5822% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Indiana

How Pediatrics Physician compares to other specialties among Indiana providers

Indiana providers

Pediatrics Physician share within Indiana

1. Pediatrics Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Pediatrics Physician share within Indiana

Medicare quality performance — MIPS

KETAN SHETH, MD's 2023 MIPS final score plotted against the Pediatrics Physician national average

High performer (top quartile)
MIPS Final Score
96.6822/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Pediatrics Physician) — 96.6822/100 vs national avg 83.1

0%100%National avg83%96.7%
MIPS final score (Pediatrics Physician) — 96.6822/100 vs national avg 83.1

The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.

Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).

KETAN SHETH, MD appears in the CMS NPPES registry as a Pediatrics Physician provider holding MD credentials at 1345 UNITY PL, LAFAYETTE, IN, 47905, with a listed phone of (765) 446-5040. NPI 1245209832 was issued on 03/16/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what SHETH most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.

Medicare Part D records for calendar year 2023 show 513 prescription claims written by this provider, covering 68 Medicare beneficiaries and totaling roughly $147K in drug spend, split 63% brand-name and 37% generic by claim count. These figures capture only Medicare Part D — commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 96.6822/100 for the 2023 performance year (Quality 83.694), compared with the national average of 83.1.

Pediatrics Physician is a high-volume specialty nationwide, with 80,574 enrolled providers across 56 states and an average of 762 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist — always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.

Practice Address

1345 UNITY PL
LAFAYETTE, IN 47905

Provider Details

NPI 1245209832
Specialty Pediatrics Physician
Credentials MD
Gender Male
NPI Issued 03/16/2006

CMS Quality Score (MIPS)

Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.

96.6822
Final Score
Avg: 83.1
83.694
Quality
100
Promoting Interoperability

Reporting: Alternative Payment Model

Industry payments received (2024) — CMS Open Payments transparency data

The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for KETAN SHETH, MD. Source: openpaymentsdata.cms.gov.

Total received

$80

Largest payer

GlaxoSmithKline, LLC.

Most common payment type

Food and Beverage

Industry payments are not necessarily indicators of bias — they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.

Brand vs generic prescribing mix · Brand-heavy

KETAN SHETH, MD — brand share 63.0%
Specialty average (est.)

63% brand-name claims vs 37% generic, on 513 2023 Medicare Part D claims.

The federal Medicare Part D Generic Dispensing Rate national benchmark sits near 90% generic / 10% brand for primary-care prescribers, per CMS Office of the Actuary 2024 estimates. Higher brand share is common in specialty prescribing where generic equivalents are not available.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

513
Total Claims
$147K
Total Drug Cost
68
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
834
Total Day Supply
23,836
Brand vs Generic
63% brand / 37% generic
Brand Drug Cost
$136K
Generic Drug Cost
$11K

Patient Demographics

Average Patient Age
70.3 years
Avg HCC Risk Score
0.95
Gender Split
75% female / 25% male

Top Prescribed Drugs (Medicare Part D)

Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.

What KETAN SHETH, MD prescribes most

Top Medicare Part D drugs by claim count, 2023

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2023
Drug Claims
Montelukast Sodium
101
Albuterol Sulfate Hfa
Albuterol Sulfate
52
Symbicort
Budesonide/Formoterol Fumarate
49
Flovent Hfa
Fluticasone Propionate
48
Advair Diskus
Fluticasone Propion/Salmeterol
40
Breo Ellipta
Fluticasone/Vilanterol
35
Fluticasone Propionate
29
Arnuity Ellipta
Fluticasone Furoate
27
Ventolin Hfa
Albuterol Sulfate
23
Fluticasone-Salmeterol
Fluticasone Propion/Salmeterol
16

* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.

Pediatrics Physician Overview

How KETAN SHETH, MD fits within the Pediatrics Physician landscape nationally.

80,574
Pediatrics Physician Providers in US
56
States with Pediatrics Physician
762
Avg Claims per Provider

KETAN SHETH, MD's 513 claims are below the specialty average of 762.

Nearby Pediatrics Physician Providers in Indiana

Other clinicians with the same primary specialty enrolled in Indiana, drawn from the same CMS NPPES roster as SHETH.

Compare Pediatrics Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is KETAN SHETH, MD's specialty?
KETAN SHETH, MD specializes in Pediatrics Physician and practices in LAFAYETTE, Indiana. Credentials: MD.
How much does KETAN SHETH, MD prescribe under Medicare Part D?
In 2023, KETAN SHETH, MD wrote 513 Medicare Part D claims totaling $147K in drug costs for 68 beneficiaries.
What is KETAN SHETH, MD's Medicare quality score?
KETAN SHETH, MD has a CMS MIPS Final Score of 96.6822/100 (Quality: 83.694). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is KETAN SHETH, MD located?
KETAN SHETH, MD is located at 1345 UNITY PL, LAFAYETTE, IN, 47905. Phone: (765) 446-5040.
What is KETAN SHETH, MD's NPI number?
KETAN SHETH, MD's National Provider Identifier (NPI) is 1245209832, issued on 03/16/2006.
Does KETAN SHETH, MD prescribe more brand-name or generic drugs?
KETAN SHETH, MD's prescribing is 63% brand-name and 37% generic drugs by claim count, with $136K in brand drug costs.
How many Pediatrics Physician providers are there in the US?
There are 80,574 Pediatrics Physician providers across 56 states in the US. The average Pediatrics Physician provider writes 762 Medicare Part D claims per year.
What drugs does KETAN SHETH, MD prescribe most often?
Based on 2023 Medicare Part D data, KETAN SHETH, MD's most frequently prescribed drugs include Montelukast Sodium, Albuterol Sulfate Hfa, Symbicort. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does KETAN SHETH, MD accept Medicare?
KETAN SHETH, MD appears in CMS Medicare data with 513 Part D claims and 68 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify KETAN SHETH, MD's credentials?
KETAN SHETH, MD's NPI is 1245209832 with credentials MD. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.

Data Sources

Provider Directory
CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
Specialty Classification
NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
Prescribing Data
CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
Quality Performance
CMS Merit-based Incentive Payment System (MIPS) — 2023 performance year.
Limitations
Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.

See our complete data methodology for details on how we collect and process government data.

Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).

Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology