Nirav Shah

Neurologist, founder, angel investor
building

[Nirav Shah @Neuronirav]

A quick intro since I haven’t been active on X or LinkedIn.

I’m a neurologist. I built and sold Alertive to Carbon Health for multiple eight figures. Had two daughters along the way.

[Nirav Shah @Neuronirav]

@pitdesi Google owns ~10% of SpaceX. Wonder how that factors into this.

[Nirav Shah @Neuronirav]

@travisk i showed up to pitch a Translinkcapital's office in SF and they were literally in NYC and totally forgot to inform me.

i later went downstairs and pitched softbank in a wework...very surreal pre covid 2020.

[Nirav Shah @Neuronirav]

@pitdesi Probably too far but I love Ka-Tip Thai Street Food...downtown by the convention center.

[Nirav Shah @Neuronirav]

@codyschneider @jakeejacobson https://t.co/BDJPUMEjw6 building this @codyschneider
I/team can show you the demo.
@Marsadist

[Nirav Shah @Neuronirav]

@yourdadinheaven @pitdesi Funny 😄

[Nirav Shah @Neuronirav]

More states should do this!

[Governor Michelle Lujan Grisham @GovMLG]

To every medical resident and physician looking for a place to plant roots: New Mexico is calling. Free child care. Tuition-free college for your kids. And now up to $300,000 in student loan repayment for physicians. We’re working to make New Mexico The best place in America to practice medicine and build a life.

Applications for student loan forgiveness open June 1. Link in the first comment.

#NewMexico #Physicians #LoanForgiveness #NMHealth

[Governor Michelle Lujan Grisham @GovMLG]

To every medical resident and physician looking for a place to plant roots: New Mexico is calling. Free child care. Tuition-free college for your kids. And now up to $300,000 in student loan repayment for physicians. We’re working to make New Mexico The best place in America to practice medicine and build a life.

Applications for student loan forgiveness open June 1. Link in the first comment.

#NewMexico #Physicians #LoanForgiveness #NMHealth

[Nirav Shah @Neuronirav]

@recap_david Newsletter

[Nirav Shah @Neuronirav]

@gregisenberg Nice! We’re buying SaaS companies too adjacent to the main tech co we’re building inspired by idea browser, https://t.co/8CmQG5529D

[Nirav Shah @Neuronirav]

@boringlocalseo Localrank

[Nirav Shah @Neuronirav]

@pitdesi Could be 10bn exit arr by eoy…plus enterprise stickiness. Seems like he’s reverse engineering his way to the valuation…why i have no idea though

[Nirav Shah @Neuronirav]

It’s true but what do you propose? @protosphinx

The dot-com crash hurt the proverbial grandma’s retirement.

When I talk to private tech ceo/cfos they’d rather not go public. Too expensive and too onerous as a product for financing.

And there are great small cap options… just that they’re too volatile - hims, navan, wealthfront, Robinhood, Reddit, Sofi to name a few with many places to wnter even this year if you have a long term view.

[Nirav Shah @Neuronirav]

@JaySahnan very cool, still needs the infra for outreach. https://t.co/8CmQG5529D has that for when companies need to scale. this looks good for sure though!

[Nirav Shah @Neuronirav]

@arakharazian @tryramp @jasonlk - maybe figma make is helping with the comes back!

[Nirav Shah @Neuronirav]

Funny how all the AI buble talk disappeared.

[Nirav Shah @Neuronirav]

Anthropic just surpassed OpenAI in revenue for the first time.

January 2025: $1B ARR >>April 2026: $30B ARR
OpenAI is at $24B and missed reportedly missed sales targets.

The company built by people who left OpenAI just lapped it which is a testament to focus and execution (accounting issues aside).

Look at the developer layer. Claude Code launched mid-2025 with Cursor already near $1B ARR built mostly on top of Claude Code.

Both Cursor and Anthropic have had negative gross margins. Cursor's problem is structural, they pay API costs they cannot escape hence the xAI deal.

Anthropic's is reportedly gross margin positive now while being compute constrained.

By April 2026 these products are neck and neck at $2.5B. Claude Code erased a multi-year gap in 12 months.

But there's no rest for any of these teams. it’s not even close to over.

Opus 4.7 is not as great as expected and codex is pulling ahead (see screenshot).

Soon this subsidy will stop and prices will have to go up…for now it’s a lot like competing for the network effects just like lyft/uber.

Companies building AI that are focused still have a huge opportunity if they can keep their cogs low. Using openrouter or https://t.co/n8YEMdcmeM might be a good step for now but ultimately tokens might cost more until datacenter demands catch up.

Our team at https://t.co/SEa7R1ymdK's is doing this by building our own infra.

The next 18 months will be really interesting!

[Nirav Shah @Neuronirav]

@pitdesi Please write more about this and educate us.

[Nirav Shah @Neuronirav]

Ian's on to something with Summation for sure. Couldn't be more excited for what he's building!

[Ian Wong @ianwong_]

Friends don't let friends vibe analyze.

Summation Reports is live. Drop in your data, get back an executive-ready report — every number traced to its source, every claim verified.

Built for the analyses you run every week and dread every time.

https://t.co/lZht5Jpetn

DMs open if you run reports for a living.

[Nirav Shah @Neuronirav]

@dylan522p How many tokens for AI to know I’m angry 🤔