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Rachel Smith Shain, MD

Emergency Medicine · San Jose

NPI 1013530161

Medicare standing
Clear
Enrolled, allowed to bill and order, not excluded
Plans that list them
Not verified
Not the same as out of network.
Office
1

Offices

1 location · Emergency Physicians Associates San Jose PC · 131 clinicians in this group

Looking this up.

Hospitals listed: Santa Clara Valley Medical Center. That is not proof they admit you there this week.

Plan participation

Not verified

We could not verify current plan participation for this doctor. This does not mean they are out of network. Call Dr. Shain’s office at (408) 885-5000 to ask if they take your plan before you enroll.

Hospitals they work in

1 hospital

These rate the hospital, not this clinician. Most measures at most hospitals are no different from the national rate.

  • Santa Clara Valley Medical CenterSan Jose, CAAcute Care Hospital · Government - Local · Has an emergency department · Birthing-friendlyPart of Santa Clara Valley Health and Hospital System, which runs 3 hospitalsPatients rate it 3 of 5 · 70% would definitely recommend it
    Overall rating: 2 of 5 starsWorse than the national rate — SSI - Colon Surgery: 2.572, Oct 2024 – Sep 2025Better than the national rate — Central Line Associated Bloodstream Infection (ICU + select Wards): 0.563, Oct 2024 – Sep 2025Better than the national rate — Clostridium Difficile (C.Diff): 0.256, Oct 2024 – Sep 2025Better than the national rate — MRSA Bacteremia: 0.369, Oct 2024 – Sep 2025
See every measure and the patient survey for Santa Clara Valley Medical Center

Behind the star rating — Deaths: 2 better, 6 the same, 0 worse of 8 measures. Safety: 2 better, 5 the same, 1 worse of 8 measures. Readmissions: 0 better, 10 the same, 1 worse of 11 measures. The star rating is worked out from an earlier period than the measures below, so the two can disagree.

Every scored measure at Santa Clara Valley Medical Center
SSI - Colon SurgeryInfections2.572WorseOct 2024 – Sep 2025
Central Line Associated Bloodstream Infection (ICU + select Wards)Infections0.563BetterOct 2024 – Sep 2025
Clostridium Difficile (C.Diff)Infections0.256BetterOct 2024 – Sep 2025
MRSA BacteremiaInfections0.369BetterOct 2024 – Sep 2025
Abdominopelvic accidental puncture or laceration rateComplications and deaths1.25 (0.3 to 2.2) · 1,535 casesNo differentJul 2022 – Jun 2024
CMS Medicare PSI 90: Patient safety and adverse events compositeComplications and deaths1.07 (0.76 to 1.38)No differentJul 2022 – Jun 2024
Death rate among surgical inpatients with serious treatable complicationsComplications and deaths214.59 (167.38 to 261.8) · 108 casesNo differentJul 2022 – Jun 2024
Death rate for CABG surgery patientsComplications and deaths2.8 · 41 casesNoneJul 2022 – Jun 2025
Death rate for COPD patientsComplications and deaths6 · 141 casesNoneJul 2022 – Jun 2025
Death rate for heart attack patientsComplications and deaths10.2 · 124 casesNoneJul 2022 – Jun 2025
Death rate for heart failure patientsComplications and deaths8.3 · 501 casesNoneJul 2022 – Jun 2025
Death rate for pneumonia patientsComplications and deaths14.9 · 653 casesNoneJul 2022 – Jun 2025
Death rate for stroke patientsComplications and deaths10.1 · 348 casesNoneJul 2023 – Jun 2025
Hybrid Hospital-Wide All-Cause Risk Standardized Mortality RateComplications and deaths3 · 4,502 casesNoneJul 2024 – Jun 2025
Iatrogenic pneumothorax rateComplications and deaths0.24 (0.04 to 0.43) · 9,014 casesNo differentJul 2022 – Jun 2024
In-hospital fall-associated fracture rateComplications and deaths0.34 (0.15 to 0.52) · 9,216 casesNo differentJul 2022 – Jun 2024
Perioperative pulmonary embolism or deep vein thrombosis rateComplications and deaths4.54 (2.51 to 6.58) · 1,421 casesNo differentJul 2022 – Jun 2024
Postoperative acute kidney injury requiring dialysis rateComplications and deaths1.54 (0 to 3.2) · 288 casesNo differentJul 2022 – Jun 2024
Postoperative hemorrhage or hematoma rateComplications and deaths2.11 (0.66 to 3.56) · 1,446 casesNo differentJul 2022 – Jun 2024
Postoperative respiratory failure rateComplications and deaths11.61 (4.09 to 19.14) · 294 casesNo differentJul 2022 – Jun 2024
Postoperative sepsis rateComplications and deaths7.29 (3.39 to 11.2) · 299 casesNo differentJul 2022 – Jun 2024
Postoperative wound dehiscence rateComplications and deaths1.9 (0.45 to 3.36) · 333 casesNo differentJul 2022 – Jun 2024
Pressure ulcer rateComplications and deaths0.23 (0 to 0.78) · 7,538 casesNo differentJul 2022 – Jun 2024
Rate of complications for hip/knee replacement patientsComplications and deaths5.4 · 94 casesNoneApr 2023 – Mar 2025
Catheter Associated Urinary Tract Infections (ICU + select Wards)Infections0.735No differentOct 2024 – Sep 2025
SSI - Abdominal HysterectomyInfections2.573No differentOct 2024 – Sep 2025
Acute Myocardial Infarction (AMI) 30-Day Readmission RateUnplanned return visits14.6 · 185 casesNoneJul 2023 – Jun 2025
Heart failure (HF) 30-Day Readmission RateUnplanned return visits22.1 · 951 casesNoneJul 2023 – Jun 2025
Hospital return days for heart attack patientsUnplanned return visits56.3 · 128 casesNoneJul 2022 – Jun 2025
Hospital return days for heart failure patientsUnplanned return visits6.4 · 644 casesNoneJul 2022 – Jun 2025
Hospital return days for pneumonia patientsUnplanned return visits1.3 · 699 casesNoneJul 2022 – Jun 2025
Pneumonia (PN) 30-Day Readmission RateUnplanned return visits16.3 · 921 casesNoneJul 2023 – Jun 2025
Rate of emergency department (ED) visits for patients receiving outpatient chemotherapyUnplanned return visits5.7 (3.9 to 8.1) · 226 casesNo differentJan 2024 – Dec 2024
Rate of inpatient admissions for patients receiving outpatient chemotherapyUnplanned return visits12.6 (9.4 to 16.5) · 226 casesNo differentJan 2024 – Dec 2024
Rate of readmission after hip/knee replacementUnplanned return visits5.4 · 94 casesNoneJul 2023 – Jun 2025
Rate of readmission for CABGUnplanned return visits11.4 · 54 casesNoneJul 2023 – Jun 2025
Rate of readmission for chronic obstructive pulmonary disease (COPD) patientsUnplanned return visits20.3 · 242 casesNoneJul 2023 – Jun 2025
Rate of unplanned hospital visits after colonoscopy (per 1,000 colonoscopies)Unplanned return visits13.2 (9.9 to 17.4) · 702 casesNo differentJan 2022 – Dec 2024
Ratio of unplanned hospital visits after hospital outpatient surgeryUnplanned return visits1 (0.7 to 1.4) · 195 casesNo differentJan 2024 – Dec 2024

What patients said (4,032 patients answered, 29% of those asked)

Patient survey stars by topic at Santa Clara Valley Medical Center
Cleanliness3
Nurse communication3
Doctor communication3
Communication about medicines3
Discharge information2
Overall hospital rating3
Quietness2
Recommend hospital4
Share of patients giving the best answer at Santa Clara Valley Medical Center
Room was "always" clean70%
Nurses "always" communicated well73%
Doctors "always" communicated well76%
Staff "always" explained57%
Yes, staff "did" give patients this information82%
Yes, staff "did" give patients information about help after discharge82%
Doctors "always" explained things so they could understand71%
Doctors "always" listened carefully74%
Doctors "always" treated them with courtesy and respect82%
Patients who gave a rating of "9" or "10" (high)67%
Staff "always" explained new medications71%
Nurses "always" explained things so they could understand71%
Nurses "always" listened carefully69%
Nurses "always" treated them with courtesy and respect80%
"Always" quiet at night43%
"YES", patients would definitely recommend the hospital70%
Staff "always" explained possible side effects44%
Yes, staff "did" give patients information about possible symptoms83%

Original Medicare doctor bills

$16,730

Medicare paid this office $16,730 for 106 people.

This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.

Largest Original Medicare bills
Emergency department visit with high level of medical decision making80$11,361$142
Emergency department visit with moderate level of medical decision making11$1,131$103
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only50$383$7
X-ray of chest, 1 view13$90$7

Who their Medicare patients are

106 Original Medicare patients in 2024. Average age 70 · Under 65 23% · 85 and older 11% · Women 51% · Also on Medicaid 78% · Health risk score 2.52. Above the middle of the specialty; the typical emergency medicine clinician is at 2.01.

Conditions among them: High blood pressure 75% · Diabetes 51% · Chronic kidney disease 36% · Heart failure 32% · Depression 31% · Coronary heart disease 28% · Atrial fibrillation 23% · Dementia 20% · COPD 18% · Stroke 17% · Cancer 12%.

The office billed $132,086, Medicare allowed $21,987 and paid $16,730; for 221 services of 26 kinds.

Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.

Medicaid work

$16,100 in 2024

Medicaid paid $16,100 for 628 billed services this clinician did in 2024, up to 72 people in a month for one service.

Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.

Largest Medicaid services in 2024
EMERGENCY DEPARTMENT VISIT HIGH MDM261$9,669
EMERGENCY DEPT VISIT MOD MDM171$4,774
Service25$977
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only154$546
EMERGENCY DEPT VISIT LOW MDM17$134
Medicaid work by year
2024628572$16,100

Money from drug and device companies

$106 in 2023

A payment is not proof that care is biased.

Payments by company
VapothermVapotherm$106
1 payment
  • Meals for Vapotherm · 2023-06-06 · $106
See the published payment
Every published payment
VapothermMeals · 2023-06-06Vapotherm$106

Professional record

NPI
1013530161
Licence
RI LP04875
Trained
Ohio State University College of Medicine, 2020
Gender
Female
More record details
Sole proprietor
Yes
Taxonomy
Federal specialty code 207P00000X (207P00000X)
Mailing address
751 S Bascom Ave, San Jose, CA, 95128
NPI first listed
2020-05-24
NPI last updated
2025-01-14
NPI record certified
2025-01-14

This is when the NPI record was last certified, not a medical board exam.