Nirmish Shah, MD
Internal Medicine · Durham, NCNPI 1033113899
Payments from drug & device makers
What this record shows
This record is dominated by speaking fees: $522,230 of the $861,816 with a category attached, or 60.6%. 16 manufacturers reported payments, led by Global Blood Therapeutics, Inc. at 29.8% of the total. Reporting peaked in 2024 at $162,752 and has fallen 69.1% since, to $50,360 in 2025. Among internal medicine clinicians in NC with any reported payments, this total sits in the top 5% — high for the specialty, which is a reason to read the composition above rather than the number alone.
Across 612 payments — averaging $1408.20 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Global Blood Therapeutics, Inc.$257K
- Pfizer$224K
- Novartis$166K
- AstraZeneca$108K
- Agios Pharmaceuticals, Inc.$39K
- Chiesi USA, Inc.$15K
- plus $53K from 10 others
Across 199 payments — averaging $5576.91 each. Payments tied to a research study. These frequently flow through the physician to a hospital or research institution rather than to the physician personally.
- Global Blood Therapeutics, Inc.$767K
- Novartis$200K
- Agios Pharmaceuticals, Inc.$95K
- Pfizer$45K
- Sanofi US Services Inc.$1K
- Bayer$671
What the payments were for
- Consulting fees$249,78329%
- Speaking & faculty fees$522,23061%
- Travel & lodging$78,3859%
- Food & beverage$11,4181%
General payments by program year
Who reported the general payments
Companies are grouped under their corporate parent — a single manufacturer often files under several CMS reporting entities. Research and ownership payments are counted separately and are not in this table.
| Company | Payments | Total |
|---|---|---|
| Global Blood Therapeutics, Inc. | 140 | $256,632 |
| Pfizer | 169 | $224,279 |
| Novartis | 123 | $165,575 |
| AstraZeneca | 95 | $107,900 |
| Agios Pharmaceuticals, Inc. | 30 | $38,711 |
| Chiesi USA, Inc. | 12 | $15,325 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 7 | $13,143 |
| Novo Nordisk | 9 | $12,392 |
| Emmaus Medical, Inc. | 15 | $10,203 |
| Genetix Biotherapeutics Inc | 3 | $5,850 |
| Vertex | 4 | $5,378 |
| Apo-pharma Inc. | 1 | $2,740 |
| GSK | 1 | $2,000 |
| Tersera Therapeutics LLC | 1 | $862 |
| Janssen Research & Development, LLC | 1 | $715 |
| Biotissue Holdings Inc. | 1 | $111 |
What the payments were tied to
Products named in the reported payments. Only payments of $100 or more are attributed here — the typical reported payment nationally is a meal worth about $16, and listing those product-by-product would be noise.
How this compares
$861,816 in reported general payments places this provider in the 95th percentile of 3,302 internal medicine providers in North Carolina.
Medicare billing
What this is not: this is the amount Original Medicare Part B allowed for services this provider billed in 2024. It is not their income. It excludes Medicare Advantage — now more than half of all Medicare enrollment — along with Medicaid and all commercial insurance, and it is gross practice revenue before staff, rent, supplies and malpractice premiums. CMS also suppresses any figure covering ten or fewer patients, so low-volume providers appear smaller than they are.
Most prescribed under Part D
| Drug | Claims | Cost to plans & patients |
|---|---|---|
| EliquisApixaban | 12 | $6,708 |
| Hydroxyurea | 51 | $2,322 |
Paid to pharmacies, not to this prescriber.
Companies that both paid and supply prescribed drugs
These companies both reported payments to this provider and make drugs the provider prescribed under Medicare Part D in 2024. For most specialties this overlap is expected — a cardiologist who is paid by a cardiology drugmaker also treats heart disease. It is shown so the reader can see it, not because it implies anything on its own.
| Company | Paid to this provider | Part D cost of their drugs |
|---|---|---|
| PfizerEliquis | $224,279 | $6,70812 claims |
Reading this fairly. The Part D column is what drug plans and patients paid pharmacies — this provider received none of it, and it reflects how many patients they treat and what those drugs cost. Against peers, this provider's reported payments sit in the 95th percentile of 3,302 internal medicine providers in North Carolina.
Other internal medicine in Durham
- Mary KlotmanDurham$478K
- Manesh PatelDurham$435K
- Patricia LugarDurham$197K
- Rebecca RichDurham$160K
- Adam DevoreDurham$112K
- Kevin ThomasDurham$101K
- Julius WilderDurham$97K
- Richard RiedelDurham$95K
- Jennifer RymerDurham$73K
- Jamie ToddDurham$69K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Billing: Medicare Physician & Other Practitioners, data year 2024. Original Medicare Part B only.
- Identity: NPPES NPI Registry, July 2026.